Blood Cell Parameters and Predicting Coronary In-Stent Restenosis

Abstract

Major advances in coronary interventional techniques and pharmacotherapy as well as the use of drug-eluting stents (DESs) have considerably reduced the risk of in-stent restenosis (ISR). However, ISR remains a major clinical challenge. Inflammation and platelet activation are important processes that underlie the pathophysiology of ISR. Parameters related to blood cells, entailing both cell count and morphology, are useful markers of the inflammatory response and platelet activation in clinical practice. Recent studies have highlighted several new combined or derived parameters related to blood cells that independently predict ISR after DES implantation. The neutrophil/lymphocyte ratio, an inflammatory marker, is regarded as a predictor of the risk of ISR and the stability of atherosclerotic plaques. The mean platelet volume, a widely used platelet activation parameter, has been shown to be a predictor of the risk of ISR and the efficacy of antiplatelet therapy. Other markers considered include the platelet/lymphocyte ratio, red blood cell distribution width, and platelet distribution width. This review provides an overview of these parameters that may help stratify the risk of coronary angiographic and clinical outcomes related to ISR.

<p>The Predictive Value of Monocyte Count to High-Density Lipoprotein Cholesterol Ratio in Restenosis After Drug-Eluting Stent Implantation</p>

“…The rate of NSTE myocardial infarction (NSTEMI) was higher in the ISR group than in the non-ISR group (50.0% vs 16.8%, p=0.001). The rate of presence of a bifurcation lesion was higher and time between the two CAG scans was longer in the ISR group than in the non-ISR group (37.5% vs 15.3%, p=0.019; 27.5 [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] vs 23.0, [16][17][18][19][20][21][22][23][24][25][32][33][34][35] p=0.043, respectively). Angiographic and PCI results, including the rate of calcification lesion, lesion type according to the AHA classification, generation of the implanted stents, the total stent length, maximum stent diameter, and post-dilatation indication, were similar in both groups.…”

Predictive value of neutrophil-to-lymphocyte ratio on drug eluting stent restenosis in patients with type 2 diabetes mellitus

“…We have previously reviewed that several parameters of blood cells, including the NLR, platelet-to-lymphocyte ratio (PLR), red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW), [ 4 ] can be used as risk predictors for DES-ISR in different clinical settings, while NLR may be the best predictor of DES-ISR among them. [ 5 ] However, our study showed that there were no significant differences in pre-procedural levels of PLR, RDW, MPV, and PDW between ISR group and non-ISR group. Different study populations and small number of samples may explain this discrepancy.…”

The Incidence and Possible Predictors of Coronary Restenosis

“…Многими авторами рестеноз стентированного сегмента рассматривается как следствие затянувшейся воспалительной реакции в стентированном участке. Показана связь между вероятностью рестеноза и содержанием в крови пациентов различных воспалительных маркеров (вч-СРБ, моноцитарный хемотаксический белок-1, миелопероксидаза, кардиотропин-1, интерлейкин-6, показатели активности тромбоцитов) [28][29][30][31]. Согласно результатам исследований [32][33][34], повышенный уровень вч-СРБ в пред-, пери-и в постпроцедурном периодах является фактором риска рестеноза в стенте.…”