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Zhang S, Yang G, Chen Y, Liu W. miR-223-5p serves as a diagnostic biomarker for acute coronary syndrome and its predictive value for the clinical outcome after PCI. BMC Cardiovasc Disord 2024; 24:423. [PMID: 39138398 PMCID: PMC11321230 DOI: 10.1186/s12872-024-04088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Acute coronary syndrome (ACS) is a serious cardiovascular disease that severely affects the quality of life and longevity of patients. MicroRNAs (miRNAs) play a key role in the progression of ACS with significant clinical value. The aim of this study was to examine the clinical value of miR-223-5p in ACS and on the occurrence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). METHODS The plasma expression of miR-223-5p was detected by RT-qPCR. The correlation of miR-223-5p and cTnI or Gensini score was shown by the Pearson method. Risk factors for the development of ACS were analyzed by multivariate logistic regression. The efficacy of miR-223-5p in identifying patients with ACS was shown by ROC curve. The predictive value of miR-223-5p for MACE development in ACS patients within 6 months after PCI was assessed by Kaplan-Meier curve and multivariate Cox regression. RESULTS miR-223-5p levels were markedly elevated in ACS patients. miR-223-5p was found to be positively related to cTnI or Gensini score. miR-223-5p was a risk factor for ACS and significantly identified patients with ACS. MACE was more likely to occur after PCI in patients with high miR-223-5p levels, and miR-223-5p was an independent prognostic indicator of MACE. CONCLUSIONS miR-223-5p had diagnostic value for ACS and predicted MACE after PCI.
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Affiliation(s)
- Shaohua Zhang
- Cardiovascular Department, General Hospital of Central Theater Command, 627 Wuluo Road, Wuchang District, Wuhan, 430070, China
| | - Guifen Yang
- Cardiovascular Department, General Hospital of Central Theater Command, 627 Wuluo Road, Wuchang District, Wuhan, 430070, China
| | - Yuhua Chen
- Cardiovascular Department, General Hospital of Central Theater Command, 627 Wuluo Road, Wuchang District, Wuhan, 430070, China
| | - Weizhen Liu
- Cardiovascular Department, General Hospital of Central Theater Command, 627 Wuluo Road, Wuchang District, Wuhan, 430070, China.
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Shahsanaei F, Gharibzadeh A, Behrooj S, Abbaszadeh S, Nourmohammadi M. A systematic review and bioinformatic study on clinical, paraclinical, and genetic factors predisposing to stent restenosis following percutaneous coronary intervention. BMC Cardiovasc Disord 2024; 24:304. [PMID: 38877398 PMCID: PMC11177414 DOI: 10.1186/s12872-024-03955-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/22/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of clinical, laboratory, and even genetic factors make people susceptible to such a phenomenon and in fact, this is multi-factorial. We aimed to first determine the underlying clinical and laboratory risk factors for the occurrence of stent re-stenosis after PCI based on a systematic review study, and after that, through a bioinformatics study, to evaluate the related genes and microRNAs with the occurrence of stent re-stenosis. MAIN TEXT In the first step, the manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the considered keywords to introduce clinical and laboratory determinants of stent re-stenosis. In the bioinformatic phase, and following a review of the literature to identify genes and microRNAs involved in restenosis, the interaction of each gene with other genes associated with stent re-stenosis was determined by GeneMANIA network analysis and Cytoscape software. Overall, 67 articles (including 40,789 patients) on clinical and biochemical predictors for stent restenosis and 25 articles on genetic determinants of this event were eligible for the final analysis. The predictors for this event were categorized into four subgroups patient-based parameters including traditional cardiovascular risk profiles, stent-based parameters including type and diametric characteristics of the stents used, coronary lesion-based parameters including several two target lesions and coronary involvement severity and laboratory-based parameters particularly related to activation of inflammatory processes. In the bioinformatic phase, we uncovered 42 genes that have been described to be involved in such a phenomenon considering a special position for genes encoding inflammatory cytokines. Also, 12 microRNAs have been pointed to be involved in targeting genes involved in stent re-stenosis. CONCLUSIONS The incidence of stent re-stenosis will be the result of a complex interaction of clinical risk factors, laboratory factors mostly related to the activation of inflammatory processes, and a complex network of gene-to-gene interactions.
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Affiliation(s)
- Farzad Shahsanaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abdullah Gharibzadeh
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Soudabeh Behrooj
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahin Abbaszadeh
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Mahboobeh Nourmohammadi
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Liu B, Wang H, Xie W, Gong T. TRIM27 Promotes Endothelial Progenitor Cell Apoptosis in Patients with In-Stent Restenosis by Ubiquitinating TBK1. Appl Biochem Biotechnol 2024:10.1007/s12010-024-04933-3. [PMID: 38558276 DOI: 10.1007/s12010-024-04933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
Approximately 2-10% in-stent restenosis (ISR) may occur following percutaneous coronary intervention (PCI) despite the use of modern drug-eluting stents (DES); thus, our study aimed to explore the effects of tripartite motif-containing (TRIM) 27 on ISR and the underlying mechanism. For this purpose, a total of 42 patients undergoing coronary angiography who had prior coronary angiography with DES implantation were recruited. Endothelial progenitor cells (EPCs) markers (defined as CD34 and vascular endothelial growth factoreceptor-2 (VEGFR-2)) in peripheral blood were measured to asses the circulating EPC level. The TRIM family-related gene expressions were detected by reverse transcription-quantitative polymerase chain reaction. Results suggested that ISR patients had reduced CD34+VEGFR-2+ and increased apoptosis rate of EPCs, along with upregulated TRIM27 and TRIM37 and downregulated TRIM28. TRIM27 promoted and TBK1 inhibited the apoptosis rate of EPCs. Mechanically, TRIM27 interacted with TBK1 to ubiquitinate TBK1 in in vitro study. In summary, TRIM27 promoted the progression of ISR in patients after PCI by ubiquitinating TBK1, which might provide novel ideas for the clinical treatment of ISR.
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Affiliation(s)
- Bo Liu
- Department of Cardiovascular Medicine, Jingshan People's Hospital, Jingshan, 431800, Hubei, China
| | - Huai Wang
- Department of Cardiovascular Medicine, Jingshan People's Hospital, Jingshan, 431800, Hubei, China
| | - Wenhao Xie
- Department of Cardiovascular Medicine, Jingshan People's Hospital, Jingshan, 431800, Hubei, China
| | - Ting Gong
- Department of Cardiovascular Medicine, Jingshan People's Hospital, Jingshan, 431800, Hubei, China.
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Singh N, Kulkarni PP, Tripathi P, Agarwal V, Dash D. Nanogold-coated stent facilitated non-invasive photothermal ablation of stent thrombosis and restoration of blood flow. NANOSCALE ADVANCES 2024; 6:1497-1506. [PMID: 38419863 PMCID: PMC10898437 DOI: 10.1039/d3na00751k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 03/02/2024]
Abstract
In-stent restenosis (ISR) and stent thrombosis (ST) are the most serious complications of coronary angioplasty and stenting. Although the evolution of drug-eluting stents (DES) has significantly restricted the incidence of ISR, they are associated with an enhanced risk of ST. In the present study, we explore the photothermal ablation of a thrombus using a nano-enhanced thermogenic stent (NETS) as a modality for revascularization following ST. The photothermal activity of NETS, fabricated by coating bare metal stents with gold nanorods generating a thin plasmonic film of gold, was found to be effective in rarefying clots formed within the stent lumen in various in vitro assays including those under conditions mimicking blood flow. NETS implanted in the rat common carotid artery generated heat following exposure to a NIR-laser that led to effective restoration of blood flow within the occluded vessel in a model of ferric chloride-induced thrombosis. Our results present a proof-of-concept for a novel photothermal ablation approach by employing coated stents in the non-invasive management of ST.
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Affiliation(s)
- Nitesh Singh
- Centre for Advanced Research on Platelet Signaling and Thrombosis Biology, Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University Varanasi-221005 India
| | - Paresh P Kulkarni
- Centre for Advanced Research on Platelet Signaling and Thrombosis Biology, Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University Varanasi-221005 India
| | - Prashant Tripathi
- School of Physical Sciences, Jawaharlal Nehru University New Mehrauli Road New Delhi Delhi-110067 India
| | - Vikas Agarwal
- Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University Varanasi-221005 India
| | - Debabrata Dash
- Centre for Advanced Research on Platelet Signaling and Thrombosis Biology, Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University Varanasi-221005 India
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Bajeu IT, Niculescu AG, Scafa-Udriște A, Andronescu E. Intrastent Restenosis: A Comprehensive Review. Int J Mol Sci 2024; 25:1715. [PMID: 38338993 PMCID: PMC10855438 DOI: 10.3390/ijms25031715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
The primary objective of this paper is to delineate and elucidate the contemporary advancements, developments, and prevailing trajectories concerning intrastent restenosis (ISR). We aim to provide a thorough overview of the most recent developments in this area, covering various aspects such as pathophysiological insights, therapeutic approaches, and new strategies for tackling the complex challenges of ISR in modern clinical settings. The authors have undertaken a study to address a relatively new medical challenge, recognizing its significant impact on the morbidity and mortality of individuals with cardiovascular diseases. This effort is driven by the need to fully understand, analyze, and possibly improve the outcomes of this emerging medical issue within the cardiovascular disease field. We acknowledge its considerable clinical implications and the necessity for innovative methods to mitigate its effects on patient outcomes. Therefore, our emphasis was directed towards elucidating the principal facets of the condition's prevalence, expounding upon the foundational mechanisms underscoring conspicuous restenosis, and delineating the risk factors relevant in shaping the contemporary landscape of diagnostic and therapeutic modalities. This thorough examination aims to provide a comprehensive understanding of the various dimensions of the condition, including epidemiological data, pathophysiological complexities, and clinical considerations critical for evaluating and enhancing current diagnostic and treatment approaches.
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Affiliation(s)
- Ioan-Teodor Bajeu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania; (I.-T.B.); (A.-G.N.); (E.A.)
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania
| | - Adelina-Gabriela Niculescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania; (I.-T.B.); (A.-G.N.); (E.A.)
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 90 Panduri Road, 050657 Bucharest, Romania
| | - Alexandru Scafa-Udriște
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania
- Department Cardio-Thoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania; (I.-T.B.); (A.-G.N.); (E.A.)
- Academy of Romanian Scientists, Ilfov No. 3, 050044 Bucharest, Romania
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Scafa-Udriște A, Itu L, Puiu A, Stoian A, Moldovan H, Popa-Fotea NM. In-stent restenosis in acute coronary syndrome-a classic and a machine learning approach. Front Cardiovasc Med 2023; 10:1270986. [PMID: 38204799 PMCID: PMC10777838 DOI: 10.3389/fcvm.2023.1270986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/17/2023] [Indexed: 01/12/2024] Open
Abstract
Background In acute coronary syndrome (ACS), a number of previous studies tried to identify the risk factors that are most likely to influence the rate of in-stent restenosis (ISR), but the contribution of these factors to ISR is not clearly defined. Thus, the need for a better way of identifying the independent predictors of ISR, which comes in the form of Machine Learning (ML). Objectives The aim of this study is to evaluate the relationship between ISR and risk factors associated with ACS and to develop and validate a nomogram to predict the probability of ISR through the use of ML in patients undergoing percutaneous coronary intervention (PCI). Methods Consecutive patients presenting with ACS who were successfully treated with PCI and who had an angiographic follow-up after at least 3 months were included in the study. ISR risk factors considered into the study were demographic, clinical and peri-procedural angiographic lesion risk factors. We explored four ML techniques (Random Forest (RF), support vector machines (SVM), simple linear logistic regression (LLR) and deep neural network (DNN)) to predict the risk of ISR. Overall, 21 features were selected as input variables for the ML algorithms, including continuous, categorical and binary variables. Results The total cohort of subjects included 340 subjects, in which the incidence of ISR observed was 17.68% (n = 87). The most performant model in terms of ISR prediction out of the four explored was RF, with an area under the receiver operating characteristic (ROC) curve of 0.726. Across the predictors herein considered, only three predictors were statistically significant, precisely, the number of affected arteries (≥2), stent generation and diameter. Conclusion ML models applied in patients after PCI can contribute to a better differentiation of the future risk of ISR.
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Affiliation(s)
- Alexandru Scafa-Udriște
- Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Department of Cardiology, Emergency Clinical Hospital, Bucharest, Romania
| | - Lucian Itu
- Department of Image Fusion and Analytics, Siemens SRL, Brasov, Romania
- Automation and Information Technology, Transilvania University of Brasov, Brasov, Romania
| | - Andrei Puiu
- Department of Image Fusion and Analytics, Siemens SRL, Brasov, Romania
- Automation and Information Technology, Transilvania University of Brasov, Brasov, Romania
| | - Andreea Stoian
- Department of Image Fusion and Analytics, Siemens SRL, Brasov, Romania
- Automation and Information Technology, Transilvania University of Brasov, Brasov, Romania
| | - Horatiu Moldovan
- Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Department of Cardiology, Emergency Clinical Hospital, Bucharest, Romania
| | - Nicoleta-Monica Popa-Fotea
- Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Department of Cardiology, Emergency Clinical Hospital, Bucharest, Romania
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Lu Y, Wang Y, Zhou B. Predicting long-term prognosis after percutaneous coronary intervention in patients with acute coronary syndromes: a prospective nested case-control analysis for county-level health services. Front Cardiovasc Med 2023; 10:1297527. [PMID: 38111892 PMCID: PMC10725923 DOI: 10.3389/fcvm.2023.1297527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/21/2023] [Indexed: 12/20/2023] Open
Abstract
Purpose We aimed to establish and authenticate a clinical prognostic nomogram for predicting long-term Major Adverse Cardiovascular Events (MACEs) among high-risk patients who have undergone Percutaneous Coronary Intervention (PCI) in county-level health service. Patients and methods This prospective study included Acute Coronary Syndrome (ACS) patients treated with PCI at six county-level hospitals between September 2018 and August 2019, selected from both the original training set and external validation set. Least Absolute Shrinkage and Selection Operator (LASSO) regression techniques and logistic regression were used to assess potential risk factors and construct a risk predictive nomogram. Additionally, the potential non-linear relationships between continuous variables were tested using Restricted Cubic Splines (RCS). The performance of the nomogram was evaluated based on the Receiver Operating Characteristic (ROC) curve analysis, Calibration Curve, Decision Curve Analysis (DCA), and Clinical Impact Curve (CIC). Results The original training set and external validation set comprised 520 and 1,061 patients, respectively. The final nomogram was developed using nine clinical variables: Age, Killip functional classification III-IV, Hypertension, Hyperhomocysteinemia, Heart failure, Number of stents, Multivessel disease, Low-density Lipoprotein Cholesterol, and Left Ventricular Ejection Fraction. The AUC of the nomogram was 0.79 and 0.75 in the training set and external validation set, respectively. The DCA and CIC validated the clinical value of the constructed prognostic nomogram. Conclusion We developed and validated a prognostic nomogram for predicting the probability of 3-year MACEs in ACS patients who underwent PCI at county-level hospitals. The nomogram could provide a precise risk assessment for secondary prevention in ACS patients receiving PCI.
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Affiliation(s)
| | | | - Bo Zhou
- Department of Clinical Epidemiology and Evidence-Based Medicine, The First Hospital of China Medical University, Shenyang, China
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Condello F, Spaccarotella C, Sorrentino S, Indolfi C, Stefanini GG, Polimeni A. Stent Thrombosis and Restenosis with Contemporary Drug-Eluting Stents: Predictors and Current Evidence. J Clin Med 2023; 12:1238. [PMID: 36769886 PMCID: PMC9917386 DOI: 10.3390/jcm12031238] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/08/2023] Open
Abstract
Iterations in stent technologies, advances in pharmacotherapy, and awareness of the implications of implantation techniques have markedly reduced the risk of stent failure, both in the form of stent thrombosis (ST) and in-stent restenosis (ISR). However, given the number of percutaneous coronary interventions (PCI) performed worldwide every year, ST and ISR, albeit occurring at a fairly low rate, represent a public health problem even with contemporary DES platforms. The understanding of mechanisms and risk factors for these two PCI complications has been of fundamental importance for the parallel evolution of stent technologies. Risk factors associated with ST and ISR are usually divided into patient-, lesion-, device- and procedure-related. A number of studies have shown how certain risk factors are related to early (1 month) versus late/very late ST (between 1 month and 1 year and >1 year, respectively). However, more research is required to conclusively show the role of time-dependence of risk factors also in the incidence of ISR (early [1 year] or late [>1 year]). A thorough risk assessment is required due to the complex etiology of ST and ISR. The most effective strategy to treat ST and ISR is still to prevent them; hence, it is crucial to identify patient-, lesion-, device- and procedure-related predictors.
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Affiliation(s)
- Francesco Condello
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Carmen Spaccarotella
- Division of Cardiology, Department of Advanced Biomedical Science, Federico II University, 80138 Naples, Italy
| | - Sabato Sorrentino
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
- Mediterranea Cardiocentro, 88122 Naples, Italy
| | - Giulio G. Stefanini
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Alberto Polimeni
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
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Wu H, Yu T, Fan T, Liao W. Efficacy and Prediction Model Construction of Drug-Coated Balloon Combined with Cutting Balloon Angioplasty in the Treatment of Drug-Eluting Stent In-Stent Restenosis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9832622. [PMID: 36238492 PMCID: PMC9553365 DOI: 10.1155/2022/9832622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/09/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the efficacy of drug-coated balloon (DCB) combined with cutting balloon angioplasty (CBA) in the treatment of drug-eluting stent in-stent restenosis (DES-ISR) and to construct a predictive model for the occurrence of DES-ISR. Methods According to the criteria of diagnosis, inclusion, and exclusion, DES-ISR patients who were treated in the outpatient and inpatient departments of cardiovascular medicine of Second People's Hospital of Guangdong Province from July 2021 to December 2021 were included. A total of 72 cases were planned to be enrolled, including 36 cases in the control group and 36 cases in the experimental group. The control group was treated with DCB, and the experimental group was combined with CBA. The treatment success rate, coronary angiography results before and after surgery, and the incidence of major adverse cardiovascular events during the follow-up period were compared between the two groups. Seventy-two DES-ISR patients were divided into ISR group and 59 non-ISR patients were divided into non-ISR group. The clinical data of the two groups were compared to analyze the risk factors affecting the occurrence of DES-ISR, and the prediction model was established. Results The surgical success rate of the experimental group was 94.44% (34/36), which was higher than the 77.78% (28/36) of the control group (P < 0.05). The minimum lumen diameter (MLD) of the experimental group 6 months after operation was greater than that of the control group, the late lumen loss (LL) and lumen stenosis rate were higher than those in the control group, and the incidence of major adverse cardiovascular events was lower than that in the control group (P < 0.05). In the ISR group, the proportion of patients with abnormal BMI, smoking, hypertension, diabetes, and family history of coronary heart disease and multivessel coronary artery disease was higher than that in the non-ISR group, the degree of stenosis target lesion was higher than that in the non-ISR group, the diameter of target lesion and stent diameter were smaller than those in the non-ISR group, and the length of target lesion and stent length were longer than those in the non-ISR group; the number of stents was more than that in the non-ISR group (P < 0.05). Combined hypertension, multiple coronary artery lesions, stenosis target lesion degree ≥85.05%, and target lesion length ≥36.88 mm were risk factors for DES-ISR, and target lesion diameter ≥3.15 mm and stent diameter ≥3.15 mm were protective factors (P < 0.05). The prediction model of DES-ISR was obtained by multiple logistic regression analysis, P = 1[1 + e (2.281 + 3.321Xhypertension + 3.427Xumber of arterial lesions + 3.359Xstenosis target lesion degree - 3.143Xtarget lesion diameter + 0.650Xtarget lesion length - 10.159Xstent diameter)]. The Hosmer-Lemeshow test showed that Hosmer-Lemeshow χ 2 = 0.925, P =0.413; the ROC curve analysis showed that the AUC of the prediction model for the occurrence of DES-ISR was 0.924, the SE value was 0.022, and the 95% CI was 0.880-0.967. Conclusion DCB combined with CBA has good clinical efficacy in the treatment of DES-ISR, which can reduce the rate of lumen stenosis and the incidence of adverse cardiovascular events. The prediction model established according to risk factors has high predictive value for the occurrence of DES-ISR.
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Affiliation(s)
- Haokun Wu
- Guangdong Second Provincial General Hospital, Guangzhou, Guangdong 510317, China
| | - Tianhao Yu
- Guangdong Second Provincial General Hospital, Guangzhou, Guangdong 510317, China
| | - Ting Fan
- Guangdong Second Provincial General Hospital, Guangzhou, Guangdong 510317, China
| | - Wenjun Liao
- Guangdong Second Provincial General Hospital, Guangzhou, Guangdong 510317, China
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Zhang W, Ji F, Yu X, Yang C, Wang X. Retrospective study of treatment with a drug-coated balloon alone is beneficial for ostial coronary lesions. J Thorac Dis 2022; 14:1203-1211. [PMID: 35572873 PMCID: PMC9096279 DOI: 10.21037/jtd-22-270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022]
Abstract
Background The effects of ostial coronary lesion (OCL) treatment with a drug-coated balloon (DCB) alone remain controversial. This retrospective study assessed the effectiveness and safety with DCB only strategy for OCL and the factors associated with target lesion revascularization (TLR) in these patients. Methods The study retrospectively included patients whom had OCLs treated with a paclitaxel-eluting DCB only strategy from 1 May 2014 to 1 May 2017. Patients were divided into in-stent restenosis (ISR) and de novo (primary) groups. And all patients came back to hospital, and underwent clinical and also angiographic follow-up. Results Among the 44 patients with 55 OCLs, 12 (27.3%) were assigned to the ISR group and 32 (72.7%) to the de novo group. The outcomes included TLR, post-interventional lumen gain, and late lumen loss (LLL). Only 8 TLRs (7 ISR and 1 de novo) were observed after a mean follow-up of 16 months. The TLR rate in the de novo group was significantly lower than the ISR group (2.4% vs. 50%, P<0.001). The LLL was 0.07±0.63 mm. Logistic regression analysis showed that the TLR incidence was independently associated with the type of stenosis (ISR vs. de novo) after adjusting for sex [odds ratio (OR), 58.72; 95% confidence interval (CI): 4.42-779.94, P=0.002]. Conclusions Treatment with DCB alone was beneficial to patients with OCLs, particularly those with de novo lesions.
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Affiliation(s)
- Wenduo Zhang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Fusui Ji
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xue Yu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chenguang Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyue Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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