| Objective: The cardiovascular disease has become the number one killerfor threating to human health currently.Although mortality of coronary heartdisease patients have reduced significantly with further development andimprovement of medical technology, blood pressure, serum total cholesterol,blood sugar, body mass index of crowd showed an upward trend with theimprovement of people’s living standards, accelerated pace of life, so theincidence of coronary heart disease rises. The World Health OrganizationDirector-General Chen Pingfu had said:“If China does not strengthen theprevention and control of chronic diseases such as cardiovascular disease inrecently5-10years, half achievement of China’s Reform and Opening will bedepleted”. Therefore, it is very important to extensive coronary heart diseaseprevention and control work. Gruntzig gave the first cases of percutaneoustransluminal coronary angioplasty (Referred PTCA) birth in1977[1], whichcreate a new area of interventional cardiology. Sigwart, etc. used intravascularmetallic stent in coronary for the first time in1986[2], which opened a newchapter in the treatment of vascular disease with stent. Although theequipment and medication in constant progress and improvement, In-stentstenosis (Referred ISR) occurred, which still is a defect for percutaneouscoronary intervention (Referred PCI)[3]. ISR is an important complication ofcoronary stent implantation, the rate of ISR is20%to50%after3-6months[4].The restenosis rate of Bare-metal stents (Referred BMS) is20%to30%, thatcan be reduced to7%or less after adopting Drug-eluting stents (Referred DES)[5]. However, Its long-term rate of restenosis is indifference with generalbare-metal stents[6], there are still more than15percent of coronary stentimplantation in patients accept intervention again due to restenosis in a year[7].risk factors who related to ISR clinically comprising: small age (Less than60years old), diabetes, hypertension, unstable angina and merger peripheral vascular disease. The risk factors associated with coronary artery lesionsincluding:bifurcation lesions, diffuse lesions, multivessel disease and leftanterior descending artery disease[8]. The occurrence of ISR were significantlyaffected by coronary lesion diameter, length degree, the number of stents, thetotal length and stents overlapping[9,10]. In particular, the people who havediabetes and intervention restenosis history accompanied a higher incidence ofISR[11]. The percutaneous coronary intervention restenosis related factors willbe study in this paper, which will provide a theoretical basis for the preventionand treatment of in-stent restenosis.Methods:250cases of coronary angiography patients who haveexamined again after PCI in Third Hospital Department of Cardiology ofHebei Medical University were enrolled from February2010to November2013. According to the results of coronary angiography reexamination, thepatients were divided into restenosis group (inner diameter of stentstenosis>50%) and control group (No restenosis or the inner diameter of stentstenosis<50%), there were about130cases in restenosis group, and other120cases were control group. In this article, regression analysis was used to studyclinical and angiographic characteristics of two group patients, the purpose isto determine the impact of basic clinical data on patients after PCI stenosis.Comparing the the site of coronary restenosis, whether bifurcation, stentlength, pressure, whether overlapping, stent type and preoperative stenosisthrough coronary angiography to find the risk factors of stent restenosis.Moreover, Logistic regression was used to analysis the relationship of thoserisk factors and intracoronary stent restenosis.Results: It was shown in comparative results between restenosis groupand control group that there is statistical difference between the two groupsabout male, smoking, diabetes, white blood cell count, left anterior descendingartery lesions, bifurcation lesions, stent length, stent overlap. It can be foundthrough logistic regression that the patients who have a history of smoking(P=0.002), history of diabetes (P=0.046),long stent (P=0.032)and bifurcation(P=0.022) are related to coronary stent restenosis. Conclusion: Smoking, history of diabetes, longer stents, bifurcationlesions were risk factors of restenosis after PCI. Such patients should beenhanced drug treatment and control risk factors. |
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