Objective: In-stent restenosis (ISR) and lesion progression are major obstacles for a percutaneous coronary intervention (PCI). Although previous studies have suggested that inflammation and lipid profile may be involved in those pathophysiological events, it remains controversial to date. The aim of the present study was to investigate the impacts of inflammation and lipid profile on both ISR and lesion progression in patients receiving PCI and scheduled follow-up.
Methods: A retrospective analysis of 513 patients was performed in patients who underwent PCI and received coronary angiography again at an average of 7 months. The data of lipid profile and C-reactive protein (CRP) at both pre-PCI and follow-up were analyzed in patients with 94 ISR group and 65 lesion progression (progression group) alone, which was compared with 307 patients with neither ISR nor lesion progression (control group).
Results: CRP levels at pre-PCI in the ISR group were higher than those in the control group (P<0.05). The multivariate analysis indicated that the CRP levels at both pre-PCI and follow-up were significantly correlated with ISR [odds ratio (OR)=1.095, 95% confidence interval (CI) 1.005-1.194 for pre-PCI, OR=1.156, 95% CI 1.054-1.267 for follow-up, P<0.05, respectively]. When the cut-off of CRP was 2 mg/l, logistic regression analysis suggested an increased risk of ISR in patients with greater than 2 mg/l (OR=1.89, 95% CI 1.031-3.465) at pre-PCI CRP. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) at follow-up in the progression group were higher than those in the control group (P<0.05, respectively). Logistic regression showed that the risk for lesion progression was associated with the concentrations of TC, LDL-C, and non-HDL-C (P<0.05).
Conclusion: The levels of pre-PCI CRP were strongly associated with ISR, whereas diabetes, serum levels of TC, LDL-C, and non-HDL-C were significantly correlated with coronary lesion progression.