Predictors of in-stent restenosis in coronary heart disease patients complicating with diabetes mellitus within 2 years after drug-eluting stents implantation.

Jinsong Chen; Yundai Chen; Feng Tian; Yunfeng Han; Jing Jing; Jie Liu; Jing Wang; Shanshan Zhou

Return

Predictors of in-stent restenosis in coronary heart disease patients complicating with diabetes mellitus within 2 years after drug-eluting stents implantation.

Author: Jinsong CHEN ¹ ; Yundai CHEN ² ; Feng TIAN ¹ ; Yunfeng HAN ¹ ; Jing JING ¹ ; Jie LIU ¹ ; Jing WANG ¹ ; Shanshan ZHOU ¹
Author Information

1. Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
2. Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China. Email: cyundai@medmail.com.cn.
Publication Type:Journal Article
MeSH: Aged; Coronary Disease; complications; epidemiology; therapy; Coronary Restenosis; etiology; Diabetes Mellitus; epidemiology; Drug-Eluting Stents; Female; Humans; Logistic Models; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies
From: Chinese Journal of Cardiology 2014;42(1):14-18
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo determine predictors for in-stent restenosis (ISR) within 2 years after drug-eluting stent (DES) implantation in coronary heart disease patients complicating with diabetes mellitus and to establish predictive model.
METHODSWe retrospectively analyzed clinical data of patients underwent DES implantation in our hospital between January 2005 and December 2012. Using random number generated by SPSS 17.0, a total of 3 073 cases were randomly divided into two cohort, model derivation cohort (MDC) and model validation cohort (MVC). MDC (2 048 cases) was divided into in-stent restenosis (ISR) group and control group. Predictors were identified using univariable and multivariable logistic regression analysis in MDC. Integer point values were assigned to each predictor based upon their β coefficient in multivariable logistic regression model to establish scoring model. The summed scores of each case in MVC (1 025 cases) were calculated to test predictive ability of the model.
RESULTSOf all these 3 073 cases, 217 cases (7.1%) were diagnosed with ISR within 2 year after DES implantation. The incidence of ISR within 2 year after DES implantation was 7.3% (149 cases) in MDC and logistic regression analysis identified six ISR risk factors: multiple target vessels (OR = 3.69, 95%CI: 2.65-8.93, P = 0.000), diffused lesions (OR = 2.92, 95%CI: 2.03-6.46, P = 0.000), GFR < 60 ml×min(-1)·1.73 m(-2) (OR = 4.73, 95%CI: 3.51-10.62, P = 0.000), smoking (OR = 3.37, 95%CI: 2.39-8.46, P = 0.000), age < 60 years old (OR = 1.44, 95%CI:1.26-4.63, P = 0.024), HbAlc ≥ 6.3% (OR = 2.48, 95%CI: 1.84-4.27, P = 0.002). Risk score was well associated with the rate of ISR in MVC. Sensitivity was 76.5% (95%CI: 64.6%-85.9%), specificity was 76.1% (95%CI: 73.2%-78.7%), and areas under the ROC curve was 0.851(95%CI:0.813-0.890, P = 0.000) when score was set at 5.5.
CONCLUSIONSThe incidence of ISR in coronary heart disease patients complicating with diabetes mellitus within 2 years after DES implantation is relatively low. Several factors are associated with ISR in these patients and risk for ISR could be reliably identified by the established scoring model.