Analysis Of The Influencing Factors Of The Restenosis In Coronary Drug Eluting Stents

Objective: to analyse the coronary artery Restenosis after drug-eluting stent implantation(Drug eluting stents-in stent restenosis,DES ISR)the influence of factors,in order to for DES ISR provide theoretical basis for the prevention and treatment,to guide future economy and safely use of coronary artery drug eluting stents(drug eluting stent,DES)to offer help.Methods: choose between January 2014 and December 2017 in our hospital success with DES implantation,and 6 to 12 months in the hospital after the operation to complete Coronary angiography(Coronary angiography,the CAG)follow-up of 403 cases of patients,according to the results of the review procedure is divided into stent restenosis(in stent restenosis,ISR)group and the non-ISR group.The basic medical history,blood biochemical indexes,pathological vascular characteristics and surgical related information of the two groups were analyzed retrospectively.The correlation between the two groups and DES-ISR was analyzed by single factor test and multiple Logistic regression.Results: History and biochemical indicators,two groups of patients in age,sex,body mass index(BMI),clinical diagnosis,smoking,do you have any history of high blood pressure,presence of diabetes history,triglyceride(TG),high-density lipoprotein(HDL),serum creatinine,homocysteine,fibrinogen,neutrophils-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)had no statistical difference(P > 0.05),In terms of Hemoglobin a1c(Hb A1c),total cholesterol(TC),low-density lipoprotein(LDL),serum Cystatin C(Cys C),uric acid,CYP2C19 slow metabolism type,and emergency surgery,the ISR group was significantly higher than the non-isr group,while the ISR group was significantly lower than the non-isr group,with statistically significant differences(P<0.05).Lesion blood vessel related aspects,ISR group with the ISR group in the area of stent placement,chronic occlusion(CTO)lesion,ostial,accompanied by myocardial bridge,the degree of stenosis and plaque type,lesion blood vessel into the corner had no statistical difference(P > 0.05),in terms of calcification and bifurcation lesions,ISR group significantly more than the ISR group of patients,the difference was statistically significant(P < 0.05);As for surgical data,there was no difference between the ISR group and the non-isr group in the length of the stent,diameter of the stent,whether the stent overlapped,postoperative dilation,maximum balloon diameter and maximum balloon dilation pressure(P>0.05).Multivariate Logistic regression analysis showed that Hb A1 c,LDL,Cys C,serum uric acid,CYP2C19 slow metabolism and emergency surgery were independent risk factors for DES-ISR,while serum bilirubin was protective factor for DES-ISR.Conclusion: among the many factors that affect DES-ISR,high values of Hb A1 c,LDL,Cys C,and serum uric acid may increase the incidence of ISR.In addition,patients undergoing emergency percutaneous coronary intervention(PCI)and CYP2C19 genotypes who are slow metabolizing may also have an increased risk of ISR.High serum total bilirubin can prevent ISR to some extent.