The relationship between neutrophil–lymphocyte ratio and in-stent restenosis in superficial femoral artery

Yang, Yaobo; F, Ge; Shen, Jing; Song, Jianbo; Xie, Jiapei; Qu, Jiangshuai; Mao, Xinzu; Kuang, Zhaocheng; Wang, Xiang; Wu, Yejun; Wang, Shenghai; Liang, Xiao

doi:10.1042/bsr20193448

Cited by 6 publications

(10 citation statements)

References 30 publications

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“…Upon physical manipulation of the occluded vessel during balloon inflation, the vascular wall injury promptly causes local activation of inflammation, which leads to increase systemic inflammation. 18 NLR as an important measure of inflammation from routine blood counts could increase in a short period after endovascular surgery, 8 which was consistent with our observation.…”

Section: Discussionsupporting

confidence: 90%

“…Finally, previous studies suggested that the PLR and NLR can be used as risk predictors for restenosis in patients after the endovascular treatment of cardiovascular disease. 8-11,22 While the NLR may be the best predictor of restenosis, 28 our findings were based on the postoperative NLR, with NLR during the follow-up not evaluated.…”

Section: Discussionmentioning

confidence: 83%

“…Chang et al 10 reported that the preoperative NLR was an independent predictor for early (within 1 year) ISR in patients with femoropopliteal chronic total occlusion. According to Yang et al, 8 postoperative NLR as well as the NLR change ratio could be used as a prognostic marker of the occurrence of ISR in superficial femoral artery, while NLR change ratio may be the best predictor of ISR. Lee et al 9 conducted a study shown that the platelet-to-lymphocyte ratio (PLR) as well as NLR was significantly associated with the risk of ISR after infrainguinal angioplasty.…”

Section: Discussionmentioning

confidence: 99%

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Relationship Between Neutrophil–Lymphocyte Ratio and Drug-Coated Balloon Restenosis in Patients With Femoropopliteal Arterial Disease

et al. 2022

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We investigated the relationship between neutrophil–lymphocyte ratio (NLR) and restenosis in patients with femoropopliteal arterial disease following drug-coated balloon (DCB) angioplasty. Patients (n = 120) were divided into 3 groups according to the development of restenosis and the time of restenosis occurrence. The postoperative NLR was higher in the late-restenosis group than that in the no-restenosis group (3.53 vs 2.70; p = .011). In multivariate logistic analysis, postoperative NLR was an independent predictor of late restenosis (odds ratio: 1.404, 95% confidence interval: 1.073–1.839; p = .014). The postoperative NLR cutoff value for predicting late restenosis was 2.78 with a sensitivity of 80.8% and a specificity of 53.2% (area under the ROC curve was .666 (95% CI: .541–.791, p = .010). The incidence of late restenosis in the NLR ≥2.78 group was higher than that in the NLR <2.78 group (32.3 vs 9.1%; p = .002). Postoperative NLR is independently associated with late restenosis in patients treated with DCB for femoropopliteal arterial disease.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Relationship Between Neutrophil–Lymphocyte Ratio and Drug-Coated Balloon Restenosis in Patients With Femoropopliteal Arterial Disease

et al. 2022

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“…Furthermore, the neutrophil-to-lymphocyte ratio (NLR) after procedure of stent implantation to SFA, as well as the NLR change ratio, but not NLR before the procedure, may be useful in assessing of the risk of ISR. NLR after a procedure higher than 4.3 was shown to have 75% sensitivity and 76% specificity for the prediction of the occurrence of ISR [75]. According to Chang et al, the NLR cut-off point of 3.62 has a sensitivity and specificity of 73.4% and 80.4%, respectively, to predict the occurrence of ISR in the first year after the procedure in patients undergoing femoropopliteal stenting due to chronic total occlusion (CTO) [76].…”

Section: Inflammatory Cellsmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

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Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice.

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“…As a starting point, new factors for inflammatory response and lipid metabolism have emerged in recent years. Such as the neutrophil/lymphocyte ratio 12,13 , which reflects the body's levels of oxidative stress and inflammation, as well as residual cholesterol, which is a more accurate indicator of the body's lipid metabolism than LDL cholesterol. 14,15 Secondly, the majority of prediction models lacked a quantitative predictor of coronary lesions before PCI, such as the GS score system, a technique based on the artery morphology, coronary anatomy, and severity of stenosis in lesions.…”

Section: Introductionmentioning

confidence: 99%

A Nomogram for Predicting In-Stent Restenosis Risk in Patients Undergoing Percutaneous Coronary Intervention: A Population-Based Analysis

Luo¹,

Tan²,

Zhao³

et al. 2022

IJGM

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In-stent restenosis (ISR) is a fatal complication of percutaneous coronary intervention (PCI). An early predictive model with the medical history of patients, angiographic characteristics, inflammatory indicators and blood biochemical index is urgently needed to predict ISR events. We aim to establish a risk prediction model for ISR in CAD patients undergoing PCI. Methods: A total of 477 CAD patients who underwent PCI with DES (drug-eluting stents) between January 2017 and December 2020 were retrospectively enrolled. And the preoperative factors were compared between the non-ISR and ISR groups. The least absolute shrinkage and selection operator (LASSO) and multi-factor logistic regression were used for statistical analysis. The prediction model was evaluated using receiver operator characteristic (ROC) analysis, the Hosmer-Lemeshow 2 statistic, and the calibration curve. Results: In this study, 94 patients developed ISR after PCI. Univariate analysis showed that post-PCI ISR was associated with the underlying disease (COPD), higher Gensini score (GS score), higher LDL-C, higher neutrophil/lymphocyte ratio, and higher remnant cholesterol (RC). The multi-factor logistic regression analysis suggested that remnant cholesterol (odds ratio [OR] = 2.09, 95% confidence interval , P < 0.001), GS score (OR = 1.01, 95% CI [1.00, 1.02], P = 0.002), medical history of COPD (OR = 4.56, 95% CI [1.98,10.40], P < 0.001), and monocyte (OR = 1.30, 95% CI [1.04, 1.70], P < 0.001) were independent risk factors for ISR. A nomogram was generated and displayed favorable fitting (Hosmer-Lemeshow test P = 0.609), discrimination (area under ROC curve was 0.847), and clinical usefulness by decision curve analysis. Conclusion: Patients with certain preoperative characteristics, such as a history of COPD, higher GS scores, higher levels of RC, and monocytes, who undergo PCI may have a higher risk of developing ISR. The predictive nomogram, based on the above predictors, can be used to help identify patients who are at a higher risk of ISR early on, with a view to provide post-PCI health management for patients.

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The relationship between neutrophil–lymphocyte ratio and in-stent restenosis in superficial femoral artery

Cited by 6 publications

References 30 publications

Relationship Between Neutrophil–Lymphocyte Ratio and Drug-Coated Balloon Restenosis in Patients With Femoropopliteal Arterial Disease

Relationship Between Neutrophil–Lymphocyte Ratio and Drug-Coated Balloon Restenosis in Patients With Femoropopliteal Arterial Disease

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

A Nomogram for Predicting In-Stent Restenosis Risk in Patients Undergoing Percutaneous Coronary Intervention: A Population-Based Analysis

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