1.Comparative analysis of cardio-metabolic risk factors in coronary artery disease patients with in-stent restenosis after percutaneous coronary intervention
Yingsheng ZHOU ; Shenhui SU ; Yadi TANG ; Xiaopeng SHI ; Yinan ZHAO
Chinese Journal of Geriatrics 2020;39(4):386-390
Objective:To analyze the characteristics of cardio-metabolic risk factors coronary artery disease(CAD)patients with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods:A total of 169 patients undergone primary(T1)PCI and followed up and rechecked by coronary angiography(T2)in our hospital from 2010 to 2017 were enrolled.According to the results of coronary angiography during follow-up, patients were divided into the ISR group(n=66)and the control group(non-ISR or NISR, n=103). Patients were sub-grouped into the elderly ISR group(the E-ISR group, n=17), the elderly non-ISR group(the E-NISR group, n=19), the young ISR group(the Y-ISR group, n=49)and the young non-ISR group(the Y-NISR group, n=84). Clinical data including medical history, laboratory results, and coronary angiography records during the two hospital stays were collected.Cardio-metabolic risk factors and clinical features of coronary artery disease were analyzed for the groups.Results:The levels of systolic blood pressure, glycated hemoglobin A1c(HbA1c), fasting blood glucose(FBG), the percentage of patients with diabetes or myocardial infarction(MI)history, the coronary Gensini score and the percentage of patients with triple vessel disease were higher in the ISR group than in the NISR group(128.6±16.4) mmHg vs.(123.4±10.7) mmHg, P=0.023; (7.0±1.6)% vs.(6.2±0.9)%, P<0.001; 6.6 mmol/L vs.5.7 mmol/L, P<0.001; 53.0% vs.31.1%, P=0.004; 36.4% vs.20.4%, P=0.022; 40 vs.29, P=0.01; 57.6% vs.40.8%, P=0.033). The E-ISR group had higher systolic blood pressure and a lower glomerular filtration rate than the E-NISR group(135.9±27.2) mmHg vs.(124.1±10.8) mmHg, P=0.013; 77.5±14.4 ml·min -1·1.73 m -2vs.(84.8±9.4) ml·min -1·1.73 m -2, P=0.033), but the Y-ISR group had longer hypertension history, higher levels of low-density lipoprotein and HbA1c, and higher Gensini scores than the Y-NISR group[129.7 months vs.83.1 months, P=0.008; (2.78±1.08) mmol/L vs.(2.31±0.65) mmol/L, P=0.002; (7.2±1.7)% vs.(6.1±0.9)%, P<0.001; 41 vs.29, P=0.009]. Conclusions:Clinical features are different between elderly CAD patients and young and middle-aged CAD patients with ISR after PCI, and metabolic risk factors such as blood pressure, blood lipid and blood glucose levels should be proactively controlled