| Objective:There is less discussion about risk factors of non-target vascular plaque progression after percutaneous coronary intervention in patients with type 2 diabetes at home and abroad.This study analyzed the clinical and coronary angiographic data of patients with type 2 diabetes undergoing PCI to provide a theoretical basis for the intervention of plaque progression.Methods:A retrospective analysis of 236 patients with type 2 diabetes who underwent PCI from 2014-1 to 2017-1 in our hospital and completed follow-up was made.The biochemical parameters of the patients were retrospectively analyzed at 30,180 and 360 days after discharge.Coronary angiography and quantitative coronary angiography(QCA)were performed 9-12 months after PCI.According to QCA results,the patients were divided into rapid progression group(progressive group)and non-target plaque progression group(control group),The clinical and QCA data of the two groups were analyzed and multivariate Logistic regression analysis was used to screen the risk factors for the progression of non-target vascular plaque.Result:1.There were significant differences between the two groups in age,BMI and CKD(P=0.040,P=0.029,P=0.014).2.The statin use was statistically different between the two groups(P=0.014,P=0.023);there was a statistically significant difference in insulin use(P=0.026,P=0.011).3.The levels of HbA1c(P=0.021,0.018,0.030,0.036),Glucose(P=0.011,0.026,0.036,0.017),TG(P=0.036,0.026,0.042,0.034),HDL(P=0.016,0.048,0.034,0.015),hs-CRP(P=0.022,0.035,0.028,0.027),Fibrinogen(P=0.027,0.029,0.027,0.032)and Total Bilirubin(P=0.040,0.025,0.017,0.033)between the two groups at admission,follow-up 30 days,180 days,360 days were statistically significant(P<0.05).4.In the progression group,the proportion of multiple coronary artery lesion was higher in the SYNTAX score group than that in the control group(P=0.008).The SYNTAX score in the primary PCI group was significantly higher than that in the control group(P<0.001).The non-target vessel reference diameter was smaller in the progression group(P=0.017),and the late luminal loss rate was higher(P<0.001).5.Logistic regression analysis showed that obese patients had obesity(OR=1.017,95%CI:1.005-1.029,P=0.008),statins(OR= 0.647,95%CI:0.497-0.842,P=0.002),Insulininjection(OR=5.876,95%CI:1.817-19.001,P=0.003),HbA1c(OR=3.429,95%CI:1.263-9.308,P = 0.016),fasting plasma glucose(OR=3.769,95%CI:95%CI:1.935-7.344,P<0.001),LowHDL(OR=7.000,95%CI:2.121-23.102,P=0.001),hs-CRP(OR=1.023,95%CI:1.013-1.032,P=0.003),SYNTAX score(OR = 3.427,95%CI:1.048-11.205,P = 0.040),Non-target vessel reference diameter(OR =0.560,95%CI:0.471-0.651,P=0.002)was an independent predictor of rapid progression of non-target vascular plaque(P<0.05).6.A Logistic regression model was constructed.The x2 value of the Hosmer-Lemeshow test was 10.214(P=0.250).The area under the model’s predicted probabilities ROC curve was 0.931(95%CI:888-0.973).Sensitivity and specificity were It is 86.8%and 83.3%;the overall accuracy of prediction is 94.1%.Conclusion:1、There was a higher rate of rapid progression of non-target plaque after PCI in diabetic patients(14.8%).2、Taking statins,the reference diameter of non-target vessels was a protective factor for rapid progression of non-target vascular plaques.Obesity,insulin injection of HbAlc,fasting blood glucose,low HDL,hs-CRP,and SYNTAX score at the first time of PCI were the risk factors of rapid progression of non-target vascular plaques. |
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