Study On The Relationship Between FAR,TyG Index And In-Stent Restenosis In Patient With Coronary Heart Disease After PCI

Objective:To investigate the relationship between the ratio of fibrinogen to albumin and triglyceride fasting glucose index and in-stent restenosis in patients with coronary heart disease(CHD)after percutaneous coronary intervention.To explore the predictive value of TyG index and FAR in the occurrence of ISR in patients with coronary heart disease.Methods:Patients with coronary heart disease diagnosed by coronary angiography and first percutaneous coronary stenting(Percutaneouscoronaryintervention,PCI)in the Department of Cardiology of the first affiliated Hospital of Henan University from December 2018 to December 2021 were collected.348 patients were reexamined after coronary angiography in our hospital.A total of 348 patients were divided into ISR group(n = 82)and non-ISR group(n = 266).The general clinical data,surgical data,biochemical data,FAR and TyG index of the two groups were analyzed and compared whether there were statistical differences between the two groups.The measurement data in accordance with the normal distribution were tested by two independent samples T test,the measurement data that did not accord with the normal distribution were expressed by Mann-Whitney U rank sum test,expressed by mean ±standard deviation or quartile,and the counting data were expressed by chi-square test.The independent risk factors of ISR were analyzed by binary logistic regression.The critical value of ISR was calculated by the receiver operating characteristic(ROC)curve for the blood lipid indexes among the independent risk factors.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of FAR,TyG index and their combination in patients with coronary heart disease(CHD),and the area under the curve and the best cut-off value were calculated.Results:1.A total of 348 patients were enrolled in this study,including 82 patients in ISR group and 166 patients in non-ISR group.There was significant difference in the history of diabetes between the two groups(P < 0.05),but there was no significant difference in age,sex,body mass index,reexamination time,history of hypertension,smoking and drinking between the two groups(P > 0.05).2.There were significant differences in fasting blood glucose,fibrinogen,triglyceride,total cholesterol,low density lipoprotein cholesterol,direct bilirubin,FAR,TyG index,residual lipoprotein cholesterol(remnantlipoproteincholesterol,RLP-C)and non-high density lipoprotein cholesterol(non-high-densitylipoproteins,No-HDL-C)between the two groups.There was no significant difference in high density lipoprotein cholesterol,serum uric acid,total bilirubin and indirect bilirubin between the two groups(P > 0.05).3.There was significant difference in stent length between the two groups(P < 0.05),but there was no significant difference in stent position(such as left trunk,anterior descending branch,circumflex branch,right coronary artery),stent number and stent diameter between the two groups(P > 0.05).4.Multivariate logistic regression analysis showed that TyG index(OR=4.796,95%CI:1.513-15.204),RLP-C(OR=2.439,95%CI:1.283-4.637),No-HDL-C(OR=1.506,95%CI:1.034-2.193)and fibrinogen(OR=7.946,95%CI:3.218-19.626)was an independent risk factor for in-stent restenosis after PCI,and albumin was a protective factor for in-stent restenosis after PCI(OR=0.760,95%CI:0.590-0.979,P < 0.05).The ROC curve analysis of blood lipid indexes among the independent risk factors showed that the critical value of RLP-C was: 1.005mmol/l.The critical value of No-HDL-C was 4.015 mmol.when the critical value of No-HDL-C was higher than the critical value,the risk of ISR increased.5.The FAR,TyG index and FAR combined TyG index were analyzed under the ROC curve.The results showed that when FAR alone predicted ISR,the area under the curve was 0.733(95%CI:0.667-0.799),the best truncation value was 7.069,the sensitivity was 0.683,and the specificity was 0.741.When TyG index was used to predict ISR alone,the area under the curve was 0.726(95%CI:0.663-0.790,P < 0.05),the best truncation value was 8.991,the sensitivity was 0.805,and the specificity was 0.598.The area under the ISR curve predicted by FAR combined with TyG index was 0.828,the sensitivity was 0.683 and the specificity was 0.857.By comparison,it was found that FAR and TyG index could predict the occurrence of in-stent restenosis alone,and the combined predictive value of FAR and TyG index was better than that of single prediction.Conclusion:1.FAR and TyG index can predict the occurrence of in-stent restenosis alone,and the combination of FAR and TyG index has better predictive value for in-stent restenosis after PCI.2.TyG index,RLP-C,No-HDL-C and fibrinogen are independent risk factors for in-stent restenosis after PCI,while albumin is an independent protective factor for in-stent restenosis after PCI.