Effects Of Serum Uric Acid On Intracoronary In-stent Restenosis In Middle-aged And Old Male Patients

Objective: To explore the relationship between serum uric acid and in-stent restenosisafter coronary stent implantation in middle-aged and old male patients.Methods: All male patients older than45years old who did coronary arteryaffectionately imaging examinations and implanted stent in coronary artery in ourhospital of cardiovascular department from January2012to December2013,208patients angiographied after6months to2years due to recurrence of chest pain orregular review among them. Retrospectively collected all the patients’ generalconditions and clinical indicators, including age, smoking, hypertension, diabetes,serum cholesterol and serum uric acid, etc. All the laboratory data were obtained fromvenous blood samples in the next morning admitted to hospital, coronary arteryintervention is based on the latest clinical practice guidelines, each patient receivedaspirin plus clopidogrel(loading dose300mg) before or during coronary intervention.Unfractionated heparin100U/kg was administered at the beginning of the procedure tokeep the activated clotting time>200seconds. Use of glycoprotein IIb/IIIa inhibitorsand predilatation or postdiatation after stent implantation of the lesion was at theoperator’s discretion; the standard of successful operation is: blood vessel diameter<20%and the diameter of residual stenosis <5%, TIMI3. In-stent Restenosis wasdefined as luminal diameter narrowing of intracoronary stent by50%or greater,according to the result of coronary angiography,208patients were divided into two groups: restenosis group (19patients) and control group (189patients); Patients in thegroup of restenosis were devided into tertiles on the basis of serum uric acid levels,stent restenosis was observed in4patients in the lowest tertile (270-362μmol/L), in12in the middle tertilt(363-454μmol/L), and in3in the high tertile(455-546μmol/L).Results: Among the208patients, restenosis occurred in19patients and non-restenosisoccurred in189patients; compared to control group, HDL-C in restenosis group had nosignificant difference(P>0.05); we compared the age, smoking, hypertension, diabetes,Lp(a), LDL-C, cholesterol, triglyceride and serum uric acid levels in the two groups,and there was a statiscally significant difference between the restenosis groups andcontrol groups(P<0.05). Multivatiate logistic regression analysis revealed that serumuric acid was an independent risk factor of in-stent restenosis. Usingχ2test to analysisthe three serum uric acid level groups in restenosis group, we find that there was astatiscally significant difference among them(P<0.05).Conclusion:The serum uric acid level of middle-aged and old male is a powerful andindependent predictor of stent retenosis after stent implantation. High serum uric acidwould increase the incidence of stent restenosis, but it is not the higher level, the higherincidence. The level of serum uric acid may be linked to the incidence of stentrestenosis through proinflammatory properties and stimulation of vascular SMCproliferation.Additionally, no clinical study has examined the utility of reducing thelevel of serum uric acid with medical interventions (such as allopurinol) in such apopulation.