Study on Risk Factors and Development of a Predictive Model for Recurrent In-stent Restenosis in Patients With Coronary Heart Disease After Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2024.05.005
- VernacularTitle:冠心病患者经皮冠状动脉介入治疗后支架内再狭窄复发的危险因素及预测模型构建研究
- Author:
Chenyujiang ZHU
1
,
2
;
Zhan LYU
;
Fasheng ZHU
;
Yong WANG
;
Yongpei HUANG
;
Tianjie WANG
;
Weixian YANG
Author Information
1. 川北医学院 临床医学系,南充 637000
2. 四川省什邡市人民医院 心内科,什邡 618400
- Keywords:
coronary heart disease;
percutaneous coronary intervention;
recurrent in-stent restenosis;
risk factor;
prediction model
- From:
Chinese Circulation Journal
2024;39(5):456-463
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the risk factors for recurrent in-stent restenosis(R-ISR)in patients with coronary heart disease after percutaneous coronary intervention(PCI)and to develop a risk prediction model for R-ISR using a nomogram. Methods:All patients treated for ISR at the Fuwai Hospital,Chinese Academy of Medical Sciences from January to December 2017 were eligible for this study.A total of 1 102 ISR patients were included for analysis.Based on the recurrence of ISR after PCI,patients were divided into R-ISR group and non-R-ISR group.Univariate Cox regression analyses,LASSO regression analyses,and the combination of clinical experience were used to select predictors of R-ISR.A multivariate Cox regression model was used to analyze the independent risk factors of R-ISR and to develop a risk prediction model. Results:The median follow-up duration for participants was 1 264(1 169,1 334)days,the incidence rate of R-ISR after PCI was 10.1%.Multivariate Cox regression analysis showed that age(HR=0.98,95%CI:0.96-0.99),total bilirubin(HR=0.95,95%CI:0.91-0.99),apolipoprotein A1(HR=0.08,95%CI:0.02-0.42),high-sensitivity C-reactive protein(HR=1.05,95%CI:1.01-1.10),and reference vessel diameter(HR=0.65,95%CI:0.44-0.98)were independent determinants of R-ISR.Accordingly,the R-ISR risk prediction model was developed with a nomogram,the AUC of this model to predicto R-ISR was 0.70(95%CI:0.64-0.77). Conclusions:Coronary heart disease patients with younger age,lower levels of total bilirubin and apolipoprotein A1,smaller vessel diameter,and higher levels of high-sensitivity C-reactive protein are at higher risk of R-ISR.The developed visual risk prediction model for R-ISR shows promising predictive performance but still requires further optimization and validation.
