Correlation Between Serum HbA1c Levels And In-stent Stenosis After PCI In Patients With Coronary Artery Disease Combined With Type 2 Diabetes Mellitus

Objective:Venous blood was collected from patients with coronary artery disease combined with type 2 diabetes mellitus at the time of repeat angiography after PCI,and the correlation between their serum levels of erythrocytes,platelets,total cholesterol,triglycerides,HDL,LDL,C-reactive protein(CRP),phospholipase A2(Lp-PLA2),and glycated hemoglobin(HbA1c)and in-stent stenosis(ISR),by comparing The correlation between each index between ISR and non-ISR groups.To investigate whether these indicators can be used as biomarkers for predicting in-stent stenosis,and to provide a reference for assessing disease severity,prognosis,and individualized treatment.Methods:According to the 2018 American Heart Association(AHA)diagnostic criteria for coronary heart disease and the 2020 American Diabetes Association(ADA)diagnostic criteria for type 2 diabetes mellitus 205 patients with coronary heart disease combined with type 2 diabetes mellitus attending the Department of Cardiology of Henan Provincial People’s Hospital from October 2020 to October 2021 were selected;their clinical data were collected,including general condition,previous surgical history,medication history,personal The clinical data included general,previous surgical history,medication history,personal history and family history;the postoperative angiograms were reviewed 8-12 months later and venous blood was collected at the time of their review;ISR was defined as the reappearance of lumen diameter stenosis(DS)>50%in the stent or in the 5mm proximal or distal segment adjacent to the stent at the follow-up angiogram;serum erythrocytes,platelets,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,and C-reactive lipoprotein were statistically analyzed in patients with coronary artery disease combined with type 2 diabetes mellitus.LDL,C-reactive protein(CRP),phospholipase A2(Lp-PLA2)and glycosylated hemoglobin(HbA1c)levels were correlated with ISR,and the correlation between HbAlc between ISR and non-ISR groups and the predictive value of HbA1c on ISR at preoperative and follow-up were compared and analyzed.Result:1.Compared with the non-ISR group,the levels of serum triglycerides,phospholipase A2,preoperative glycated hemoglobin,and follow-up glycated hemoglobin were significantly elevated in the ISR group,and the difference was statistically significant(P<0.05);the serum high-density lipoprotein was lower in the ISR group,and the difference was statistically significant(P<0.05).2.Compared with the non-ISR group,the serum LDL,C-reactive protein and fasting glucose were mildly increased in the ISR group,and the difference was not statistically significant(P>0.05).3.Multi-factor logistic regression analysis suggested that triglycerides(OR=1.907,95%CI:1.1153.264,P=0.018),preoperative glycated hemoglobin(OR=0.345,95%CI:0.193-0.617,P<0.001),glycated hemoglobin at follow-up(OR=9.371,95%CI:3.787-23.186,P<0.001)were independent risk factors for ISR.4.The area under the ROC curve for HbAlc at follow-up was 0.745(95%CI:0.666-0.823,P<0.01),with a cut-off value of 7.35%,sensitivity 88.2%,and specificity 53.8%;the area under the ROC curve for preoperative HbA1c was 0.635(95%CI:0.543-0.727,P=0.013).Conclusion:1.Serum levels of glycated hemoglobin,triglycerides and phospholipase A2 in patients with coronary artery disease combined with type 2 diabetes mellitus were significantly correlated with the occurrence of in-stent restenosis before surgery and at follow-up.2.Serum levels of C-reactive protein,low-density lipoprotein and fasting glucose were not significantly correlated with the occurrence of in-stent restenosis in patients with coronary artery disease combined with type 2 diabetes mellitus.3.HbA1c may be a biomarker for predicting in-stent stenosis before surgery and at follow-up,providing a reference basis for assessing disease prognosis and individualized and precise treatment.4.Whether C-reactive protein and low-density lipoprotein can become serum markers of in-stent stenosis needs further study,such as expanding the sample size and increasing the follow-up nodes.