Non-Fasting Hypertriglyceridemia as an Independent Risk Factor for Coronary In-Stent Restenosis after Primary Bare Metal Stent Implantation in Patients with Coronary Artery Disease

Int Heart J. 2021;62(5):970-979. doi: 10.1536/ihj.21-015.

Abstract

After a percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD), in-stent neoatherosclerosis may pose a risk of in-stent restenosis (ISR). To clarify whether non-fasting hypertriglyceridemia contributes to ISR, we examined the relationship between non-fasting hypertriglyceridemia (i.e., triglyceride (TG) level ≥ 200 mg/dL) and ISR after stenting with a bare metal stent (BMS) post-primary PCI in patients with CAD by means of a single-site retrospective analysis. A total of 1,039 patients with CAD were enrolled, and 86 patients (112 lesions) were evaluated for BMS-ISR 3-6 months post-primary PCI. The percentage of patients with non-fasting hypertriglyceridemia was significantly higher in the ISR (+) group than in the ISR (-) group (P < 0.009). The follow-up period and number of patients in the ISR (+) group were significantly smaller than those in the ISR (-) group (P < 0.001). There were no significant between-group differences in the other baseline patient characteristics before the primary PCI or at the time of the follow-up coronary angiography. However, at the follow-up period, the ISR (+) group had significantly lower diastolic blood pressure and high-density lipoprotein cholesterol levels (P = 0.015) and significantly higher TG levels (P = 0.012) than the ISR (-) group. A multiple logistic regression analysis demonstrated that non-fasting hypertriglyceridemia and a follow-up period of ≥ 6 months were independent risk factors for ISR after primary PCI in patients with BMS implantation for stenotic CAD (P = 0.006), with an adjusted odds ratio of 8.232 (1.201-56.410) and 0.006 (95% confidence interval < 0.001-0.045), respectively. Non-fasting hypertriglyceridemia may be an additional independent risk factor for BMS-ISR after primary PCI in patients with CAD.

Keywords: Dyslipidemia; Percutaneous coronary intervention; Residual cardiovascular risk; Retrospective study.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / surgery*
  • Coronary Restenosis / epidemiology*
  • Coronary Restenosis / etiology*
  • Fasting
  • Female
  • Humans
  • Hypertriglyceridemia / complications*
  • Male
  • Metals
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery*
  • Prosthesis Design
  • Prosthesis Implantation
  • Retrospective Studies
  • Risk Factors
  • Stents*

Substances

  • Metals