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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Predictive Value Analysis of in-Stent Restenosis Within Three Years in Older Acute Coronary Syndrome Patients: A

Jing Zhou1, Dayang Chai1, Yuxiang Dai2

  • 1Department of Cardiology, 442535The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|June 16, 2022
PubMed

Insights

Higher red cell distribution width (RDW) and smaller minimum stent diameter predict in-stent restenosis (ISR) in older acute coronary syndrome (ACS) patients within 3 years after drug-eluting stent (DES) implantation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomarkers

Background:

  • In-stent restenosis (ISR) is a significant complication after drug-eluting stent (DES) implantation in patients with acute coronary syndrome (ACS).
  • Predicting ISR in older ACS patients is crucial for timely intervention and improved outcomes.
  • Identifying novel prognostic factors can enhance risk stratification and clinical management.

Purpose of the Study:

  • To investigate prognostic factors for ISR within 3 years in older ACS patients treated with DES.
  • To establish and validate a clinical predictive model for ISR in this population.

Main Methods:

  • Retrospective analysis of 215 older ACS patients undergoing coronary angiography after DES implantation.
  • Logistic regression analysis to identify independent predictors of ISR.
  • Development and assessment of a clinical predictive nomogram using decision curve analysis (DCA) and clinical impact curve (CIC).

Main Results:

  • Elevated red cell distribution width (RDW) was independently associated with a higher risk of ISR (OR=1.54, p<0.01).
  • Smaller minimum stent diameter was independently associated with a lower risk of ISR (OR=0.28, p=0.03).
  • The developed nomogram demonstrated good predictive performance (C-index=0.710) and clinical utility.

Conclusions:

  • Higher RDW levels and lower minimum stent diameter are significant predictors of ISR in older ACS patients post-DES implantation.
  • The developed clinical nomogram offers valuable utility for predicting ISR within 3 years.
  • These findings can aid in personalized risk assessment and management strategies for older ACS patients receiving DES.

Keywords:
drug-eluting stentin-stent restenosiskaplan-meier curvenomogramolder patients

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