Related Factors Of Target Vessel Restenosis After Drug-Coated Balloon Angioplasty In De Novo Lesions Of Large Coronary Arteries

ObjectiveExploration of target vessel restenosis after drug-coated balloon(DCB)angioplasty in de novo lesions of large coronary arteries,and to observe the related factors of target vessel restenosis after DCB angioplasty.MethodsIn May 2017 to 2022 were retrospectively analyzed in June at Fuwai Huazhong cardiovascular Disease Hospital of Henan University People’s Hospital treated 373 cases of coronary heart disease(CHD)in patients with clinical data: Age,gender,BMI,family history of CHD,smoking,drinking,hypertension,diabetes,hyperlipidemia,TC lever,TG lever,LDL-C lever,HDL-C lever,thyroid dysfunction,history of PCI,CRP,left atrial diameter,left ventricular diameter,LVEF,coronary Gensini score,disease type,length of target lesion,diameter of target lesion,location of target lesion,number of diseased vessels,whether intraoperative spinous process balloon/cutting balloon pre-dilation was used during surgery,and whether IVUS/OCT was used during surgery,the degree of residual stenosis immediately after surgery,the time of postoperative review,the degree of residual stenosis after surgery,etc.All of them were treated with DCB angioplasty and underwent CAG review 6 to 13 months after the operation.Target vessel restenosis was defined as stenosis of ≥50% of the inner diameter of target vessel lesions on QCA.The occurrence of restenosis in the target lesions of the patients was counted,and the patients with restenosis(51 cases)were set as the occurrence group,and the patients without restenosis(322 cases)were set as the non-occurrence group.Compare two groups of patients with clinical data and target vascular characteristics.Using Logistic regression analysis,the analysis of the influence factors of target vascular restenosis.Results:A total of 400 target vessels were included in 373 patients,51 patients(13.67%,55 target vessels with restenosis)and 322 patients with no restenosis(86.33%,345 target vessels without restenosis).In stenosis group,the rates of diabetes mellitus(31.37%),smoking history(37.25%,15.69%),and preoperative LDL-C levels [(3.70±0.74)mmol/L,(3.00±0.96)mmol/L] were higher than those in non-stenosis group [23.29%,18.94%,6.21%,(3.05±0.56)mmol/L,(2.73±0.87)m mol/L](P<0.05).Compared with the non-occurrence group,the residual stenosis degree in the occurrence group were increased([(25.14±1.03)%] vs [(20.33±1.15)%]),the length of the target lesion was increased([(19.02±1.78)mm] vs [(16.32±2.15)mm]),and the proportion of pre-dilation without intraoperative spinous process balloon/cutting balloon was decreased(99.13% vs 94.55%),and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the history of smoking(OR=2.683,95%CI:2.025～3.341,P=0.005),diabetes mellitus(OR=3.473,95%CI:2.415～4.531,P=0.009),preoperative high LDL-C level(OR=4.735,95%CI:3.021～6.449,P<0.001),high intraoperative residual stenosis(OR=3.473,95%CI:2.379～4567,P<0.001),and long target lesion length(OR=5.778,95%CI:3.212～8.343,P < 0.001),and no intraoperative spinous process balloon/cutting balloon pre-dilation(OR=0.402,95%CI:0.217～0.586)were independent risk factors for target vessel restenosis(P<0.05).Conclusion: Patients with smoking history,diabetes mellitus,PCI preoperative high LDL-C level,and the degree of intraoperative long target lesion length,no intraoperative spinous process balloon/cutting balloon pre-dilation,and the degree of postoperative high residual stenosis are risk factors for target vessel restenosis after DCB angioplasty for in situ coronary artery disease.