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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Predictive Utility of PLR and Platelet-to-LDL Ratio for in-Stent Restenosis Following Carotid Artery Stenting
1Department of Clinical Laboratory, The Second Qilu Hospital of Shandong University, Jinan, Shandong, 250033, People's Republic of China.
Insights
Platelet-to-lymphocyte ratio (PLR) and platelet/LDL levels before carotid artery stenting (CAS) can predict in-stent restenosis (ISR). These biomarkers may help identify patients at higher risk for stroke recurrence after CAS procedures.
Area of Science:
- Vascular Medicine
- Biomarker Discovery
- Stroke Prevention
Background:
- Carotid artery stenting (CAS) is a common procedure to prevent ischemic stroke by restoring blood flow.
- In-stent restenosis (ISR) following CAS increases the risk of recurrent ischemic stroke.
Purpose of the Study:
- To identify predictive biomarkers for ISR after CAS.
- To evaluate the diagnostic performance of various hematologic ratios in predicting ISR.
Main Methods:
- Retrospective analysis of 221 CAS patients and 145 healthy controls.
- Analysis of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and other hematologic ratios.
- Evaluation of SII, SIRI, and AISI indices; ROC curve analysis for PLR and platelet/LDL.
Main Results:
- Increased NLR, PLR, and other ratios were observed in CAS patients.
- Elevated PLR and platelet/LDL ratios before the initial CAS were significantly associated with ISR development.
- ROC analysis indicated PLR as a strong predictor, though with modest sensitivity.
Conclusions:
- PLR and platelet/LDL ratios identified before the first CAS operation are potential predictive biomarkers for ISR.
- These biomarkers may aid in stratifying patients at risk for ISR and subsequent stroke recurrence.
Background:
Carotid artery stenting (CAS) has been widely used to remodel the vascular structure and restore the blood flow for preventing ischemic stroke. However, in-stent restenosis (ISR) after CAS is extremely associated with an increased risk of ischemic stroke recurrence.
Objective:
The aim of this study was to explore potential predict biomarkers for ISR after CAS.
Methods:
In this study, data from 221 patients with CAS, which was divided into no-ISR group and ISR group, and 145 healthy controls were retrospectively analyzed. The ratios of neutrophil, lymphocyte, monocyte, platelet, glucose (Glu), and triglyceride (TG) to lymphocyte, HDL, and LDL were analyzed, respectively. In addition, the ratios of SII, SIRI, and AISI were analyzed as the following formulas: SII = platelet × neutrophil-to-lymphocyte ratio, SIRI = monocyte × neutrophil-to-lymphocyte ratio, and AISI = neutrophil × platelet × monocyte-to-lymphocyte ratio. ROC curve analysis was performed to analyze the predict roles of PLR and platelet/LDL for ISR.
Results:
The ratios of NLR, PLR, Glu/lymphocyte, TG/lymphocyte, NHR, PHR, Glu/HDL, TG/HDL, neutrophil/LDL, platelet/LDL, Glu/LDL, TG/LDL, and SII increased in patients with CAS, indicating the predict roles of these values in carotid artery stenosis. Most importantly, increased ratios of PLR and platelet/LDL before the first operation of CAS, but not the second operation, were found in ISR patients after CAS as compared with no-ISR group. ROC analysis showed a more effective role of PLR for predicting ISR. While PLR showed high specificity (96.95%), its modest sensitivity (35.29%) suggests the need for complementary biomarkers in clinical practice.
Conclusion:
These results indicate that ratios of PLR and platelet/LDL before the first CAS operation can act as the predict biomarkers of ISR.
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