| ObjectiveThe incidence of coronary syndrome（ACS）is increasing annually,posing a significant threat and challenge to individuals and society.The widespread availability of percutaneous coronary intervention（PCI）can be of immediate benefit to such patients;however,many difficulties and challenges still remain after PCI.In-stent restenosis（ISR）is the recurrence of intravascular stenosis after PCI and is a major complication after PCI.The aim of this study was to investigate the impact of serum uric acid levels on the prognosis of PCI in patients with coronary artery disease,with an emphasis on its predictive value for ISR.MethodsThe present study included a population of patients with coronary heart disease who were admitted to hospital with chest pain between September 2014 and March 2019 and received PCI during the same period.The following cases were excluded:previous immune system disease;combined with liver or kidney dysfunction;tumor and chronic wasting disease;history of heart failure;history of diuretic use.Basic information and medical history were collected,and the serum creatinine,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,glutamic oxaloacetic transaminase（GOT）,glutamic pyruvic transaminase（GPT）,N-terminal B-type natriuretic peptide（NT-proBNP）,left ventricular ejection fraction（LVEF）,coronary angiography results and interventional operation reports were measured and recorded.The serum uric acid level was measured.According to whether the uric acid was high,they were divided into hyperuricemia group and normal uric acid group.The incidence of in-stent restenosis（ISR）and MACE were compared between two groups.Results1.A total of 345 cases including 83 cases of hyperuricemia group and 262 cases of normal uricemia group were included in this study.Compared with the baseline data of two groups,BMI（23.98±1.51 vs 22.62 ± 1.93 kg/m2;P<0.001）,serum creatinine（62.29±6.13 vs 59.36±5.22μmol/L;P<0.001）,TG（1.96 ± 0.44 vs 1.61±0.52 mmol/L;P<0.001）,LDL-C（3.86 ± 0.73 vs 3.55±0.68 mmol/L;P=0.001）,NT-proBNP（227.53 ± 107.31 vs 134.00± 33.49 pg/mL;P=0.003）was significantly higher in hyperuricemia group.Also,the incidence of hypertension is higher in hyperuricemia group（53.0%vs 39.3%;P=0.028）.There was no significant difference in age,gender,HDL-C,AST,ALT,LVEF,smoking history,diabetes history,family history of early coronary heart disease and incidence of acute myocardial infarction between two groups（P>0.05）.2.Pre-operative angiography did not show significant differences between the two groups in terms of basic lesion conditions,such as multiple lesion rate,major lesion sites,and intraoperative stents used（e.g.stent diameter,stent length）,but the Gensini stenosis score was significantly higher in the hyperuricemic population（51.17±13.82 vs.48.72±10.82;P=0.002）.3.The incidence of MACE（26.5%vs 13.7%;P=0.006）,in-stent restenosis（24.1%vs 11.1%;P=0.003）,recurrent myocardial infarction（19.3%vs 7.63%;P=0.002）,sudden cardiac death（8.43%vs 2.67%;P=0.02）was significantly higher in the hyperuricemia group than that in the normal uric acid group.There was no significant difference in the incidence of arrhythmia.4.The correlation analysis showed that the blood uric acid level in hyperuricemia group was positively correlated with BMI（R=0.518,P<0.001）,TG（R=0.455,P<0.001）,LDL-C（R=0.397,P<0.001）,hypertension（R=0.349,P=0.001）,MACE（R=0.36,P=0.001）,in-stent restenosis（R=0.306,P=0.005）and recurrent myocardial infarction（R=0.396,P<0.001）.5.Logistic regression analysis showed that hyperuricemia was an independent risk factor for restenosis after PCI（OR=2.673,95%CI:1.179～6.060）.ConclusionsPatients with coronary artery disease with hyperuricaemia are more likely to have combined hypertension and abnormal lipid metabolism.In addition,patients with coronary artery disease who have hyperuricaemia are predicted to be more susceptible to complications such as ISR and MACE after PCI.Hyperuricaemia is an independent risk factor for the development of ISR after PCI. |
