Predictors of In-Stent Restenosis

Akboğa, Mehmet Kadri; Yılmaz, Samet

doi:10.1177/0003319718776796

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Through early detection and intervention, mortality can be reduced, and medical resources can be saved. Many inflammatory markers have been found to be risk factors for ISR [ 31 ], but hs-CRP is currently the most widely used and conveniently detected inflammatory marker in clinical practice. Substantial evidence implicates hs-CRP as a risk factor for ASCVD [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of High-Sensitivity C-Reactive Protein in In-Stent Restenosis: A Meta-Analysis of Clinical Trials

Lü²,

2022

JCDD

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Background: A risk assessment of in-stent restenosis (ISR) patients is critical for providing adequate treatment. Nevertheless, the prognostic value of high-sensitivity CRP (hs-CRP) levels on ISR has not been consistently demonstrated in clinical studies. In the current meta-analysis, we aim to assess the predictive role of hs-CRP in patients treated with stenting. Methods: We searched PubMed, Web of Science, Embase, and the Cochrane Registry through May 2022. We selected random control trials that compared the effects of different interventions, and that revealed the effects of hs-CRP. Two reviewers independently screened the articles, extracted the data, and assessed the quality of the studies according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The data were pooled using a random-effects meta-analysis. Results: Nine articles were included in the meta-analysis. A total of 1.049 patients received stent implantation, and 185 ISR events were recorded during the 1–12-month follow-up period. Baseline hs-CRP levels were not associated with the prediction of ISR among patients receiving stent implantation. The OR of hs-CRP for ISR was 1.81 (0.92–2.69). In the subgroup analysis, 6–12-month hs-CRP levels, diabetes mellitus (DM), and age ≥60(years)were associated with a higher risk of ISR. Conclusions: This meta-analysis shows that higher levels of baseline hs-CRP are not associated with an increased risk of ISR in stented patients. However, an increased risk of ISR was associated with hs-CRP levels at 6 to 12 months of follow-up, which is higher in studies with diabetes mellitus patients and the elderly.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of High-Sensitivity C-Reactive Protein in In-Stent Restenosis: A Meta-Analysis of Clinical Trials

Lü²,

2022

JCDD

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“…The mechanism is mediated by a series of vascular active substances, and the process could not be prevented easily (3,4). Furthermore, the definite mechanism is not completely clear (5). The research by Lee et al (6) showed that coronary artery calcification score and cardiac enzyme (CK-MB) could predict in-stent restenosis (ISR).…”

Section: Introductionmentioning

confidence: 99%

Analyzing the Application of Myocardial Blood Flow Index in the Diagnosis of In-Stent Stenosis

Qingfeng

et al. 2021

Iran J Radiol

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Background: In-stent restenosis (ISR) usually develops from stent neointimal hyperplasia (SNH), which will seriously weaken the effect of treatment. In this study, both SNH and ISR were classified as in-stent stenosis (ISS), and a non-invasive parameter – myocardial blood flow index (MBFI) was used to analyze its value in the diagnosis of stent abnormalities. Objectives: Analyzing the application of MBFI in the diagnosis of ISS. Patients and Methods: Clinical follow-up data for 572 patients with drug-eluting stent (DES) was collected continuously. Ninety cases were screened with the protocol of computed coronary tomography angiography (CCTA) and invasive coronary angiography (ICA) for the unrelieved symptoms. In-stent abnormalities included SNH (ISS < 50%) and ISR (ISS ≥ 50%). The ROC curve was analyzed using the optimal cutoff value of MBFI to evaluate the in-stent abnormalities. T-test of independent samples was used for the comparison data with normal distribution, and chi-square test was used for comparison of nominal variables P < 0.05 was considered statistically significant. Results: Frequency of ISS was not statistically different between genders (χ2 = 0.105) (P = 0.7463). The optimal cutoff value was 0.082 with the area under the curve (AUC) of 0.829 (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 91.4%, 89.1%, 84.2%, and 94.2%, respectively, and the accuracy was 90.0%. Among 39 cases with MBFI ≤ 0.082, 34 (87.18%, 34/39) were with ISS, including 18 (20%, 18/90) of SNH, and 16 (17.9%, 16/90) of ISR. In the 39 cases with MBFI ≤ 0.082, there were eight (20.5%, 8/39) presented new lesions, and seven (17.9%, 7/39) presented severe lesions. Conclusion: MBFI could be used for evaluating ISS, and more attention should be paid to the new accompanying lesions for the high risk of severe lesions.

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