AimThe purpose of this study was to investigate the predicting value of platelet distribution width (PDW) and fibrinogen for in-stent restenosis (ISR) in patients with stable angina pectoris and type 2 diabetes mellitus (T2DM) after drug-eluting stent (DES) implantation.MethodsWe enrolled 161 patients who were readmitted with recurrent chest pain and successfully reviewed for coronary angiography and were divided into the ISR and non-ISR groups. We compared the levels of PDW and fibrinogen between the two groups. Logistic regression was used for analyzing independent predictors of ISR. The receiver operating characteristic (ROC) curve analysis was used to determine the optimum cutoff points of PDW and fibrinogen to predict ISR. The Kaplan–Meier survival curves for target lesion failure (TLF) by levels of PDW and fibrinogen.ResultsThe multivariate logistic regression analysis showed that PDW and fibrinogen were independent predictors of ISR [odds ratio (OR) = 1.209, 95% CI: 1.024–1.427, p = 0.025; OR = 1.006, 95% CI: 1.002–1.011, p = 0.010, respectively]. The ROC analyses showed that PDW ≥ 13.15% and fibrinogen ≥ 333.5 mg/dl were predictive of ISR in patients with stable angina pectoris and T2DM after DES implantation. However, the Kaplan–Meier estimate for TLF showed no statistical significance.ConclusionHigher levels of PDW and fibrinogen were associated with the incidence of ISR in patients with stable angina with T2DM after DES implantation, but were not independent predictors of TLF.

We aimed to investigate prognostic factors of in-stent restenosis (ISR) within 3 years in older acute coronary syndrome (ACS) patients after drug-eluting stent (DES) implantation and establish a clinical model for predicting ISR. We retrospectively collected 215 older ACS patients who followed coronary angiography (CAG) after DES implantation, divided into ISR group and non in-stent restenosis (non-ISR) group according to the results of reviewed CAG. Logistic regression analysis was performed to screen independent predictors related to ISR and build the clinical predictive model, which clinical application was assessed by decision curve analysis (DCA) and clinical impact curve (CIC). Kaplan-Meier survival curves for ISR by independent predictors. In multivariate logistic regression analysis showed that the red cell distribution width (RDW) was higher in ISR group compared with non-ISR (odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.14–2.08, p < 0.01). Instead, a negative correlation was observed between minimum stent diameter and ISR (OR = 0.28, 95%CI:0.09-0.86, p = 0.03). A novel nomogram composed of these significant features presented a concordance index (C-index) of 0.710, DCA and CIC suggested that the predictive nomogram had clinical utility. Schoenfeld residuals showed the model RDW ≥ 12.6% with minimum stent diameter <3 mm was consistent with the proportional risk assumption. The Kaplan-Meier estimate for ISR showed statistical significance. Higher levels of RDW and lower minimum stent diameter were associated with incidence of ISR within 3 years in older ACS patients after DES implantation.