Correlation Between Severity Of In-stent Restenosis And Glycosylated Hemoglobin In Patients With Acute Myocardial Infarction After PCI

Objective:Studies have shown that glycated hemoglobin is a risk factor for major cardiovascular adverse events,but the impact on the severity of in-stent restenosis is not clear.This study was to analyze the correlation between the severity of in-stent restenosis and the glycosylated hemoglobin in patients with acute myocardial infarction after PCI,which provides reference and evidence for clinical prevention of in-stent restenosis through retrospective study.Methods:192 patients with AMI who underwent PCI,reviewed coronary angiography and had complete data were selected from January 2014 to October 2017 in the Second Hospital of Jiaxing City.Among them,23 cases were included in the ISR group and 169 cases were included in the non-ISR group.The general clinical data,coronary vascular disease(gensini score)and laboratory test data were analyzed between two groups.The data of the two groups were compared.The statistically significant data were included in the logistic regression model to determine whether HbA1 c is an independent risk factor for ISR.The in-stent restenosis of patients with coronary angiography were graded and the differences in HbA1 c at grades were compared to determine whether HbA1 c level was associated with the severity of vascular stenosis after PCI.Results:(1)In univariate analysis,DM,WBC,stent diameter,uric acid,neutrophil count(N),calcium channel blocker(CCB),HbA1 c,follow-up time were statistically different between ISR and non-ISR groups(P<0.05).(2)After multivariate analysis,stent diameter(OR=0.114,P=0.004),HbA1c(OR=1.429,P=0.044),follow-up time(OR=1.148,P=0.015)were independent risk factors for ISR formation.(3)The degree of in-stent stenosis after PCI in HbA1c≥6.5% group was significantly higher than that in HbA1c<6.5% group(P=0.016).(4)There was a significant difference in HbA1 c levels between the grades ofin-stent restenosis(P=0.000),and the level of HbA1 c at grade IV was significantly greater than that of grades I and II.Conclusion:(1)HbA1c,stent diameter,and follow-up time were independent risk factors for ISR.(2)The severity of stenosis in the stent is related to the level of HbA1 c,that is,severe intra-stent stenosis is significantly associated with higher HbA1c levels.