Exploring the relationship between novel serum inflammatory markers, non-traditional lipid parameters, and in-stent...

Despite advances in drug-eluting stents (DES), in-stent restenosis (ISR) remains a significant cause of percutaneous coronary intervention (PCI) failure. Inflammation and lipid metabolism are implicated in ISR pathogenesis. This study aimed to investigate the correlation and predictive value of novel systemic inflammatory indices and non-traditional lipid parameters for ISR after DES implantation.

This single-center, retrospective study enrolled 564 patients who underwent initial DES implantation and received follow-up coronary angiography at least six months later. Patients were divided into ISR (n = 112) and non-ISR (n = 452) groups. Clinical data and laboratory parameters were collected. Various inflammatory indices (SII, SIRI, NLR, PLR, MLR, NPR, PIV) and non-traditional lipid parameters (AIP, AC, CRI-I, CRI-II, LCI, RC) were calculated. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with ISR. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of significant indicators.

Compared to the non-ISR group, the ISR group had significantly higher levels of SII, SIRI, NLR, PLR, MLR, PIV, CRI-II, and LCI (all P < 0.05). Adjusted logistic regression identified CRI-II (OR =  1.277, 95% CI: 1.066-1.529, p = 0.008) and LCI (OR = 1.010, 95% CI: 1.002-1.018, p = 0.020) as independent risk factors.ROC analysis showed that CRI-II had an AUC of 0.586 (P = 0.005) with a sensitivity of 75.0% and a specificity of 41.2%, while LCI demonstrated an AUC of 0.571 (P = 0.020) with a sensitivity of 58.0% and a specificity of 55.8%.None of the novel serum inflammatory markers were independently associated with ISR in the multivariate logistic regression analysis.

CRI-II and LCI, are significantly associated with ISR after PCI but show limited discriminatory ability. All AUC values were below 0.7, indicating these findings are exploratory signals only. These easily accessible biomarkers exhibit statistical associations but are not ready for clinical recommendation for ISR risk stratification.