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Platelet Distribution Width on Admission Predicts In-Stent restenosis in Patients with coronary Artery Disease and Type 2 Diabetes Mellitus Treated with Percutaneous coronary Intervention

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Chinese Medical Journal 2018年第7期131卷 757-763页

作者： Cheng-Ping Hu Yu Du Yong Zhu Chao Shi Zheng Qin Ying-Xin Zhao Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Disease Capital Medical University Beijing 100029 China

Background： It is known that there is a definite association between platelet distribution width （PDW） and poor prognosis in patients with coronary artery disease （CAD） and type 2 diabetes mellitus （T2DM）. However, there are no data available regarding the prognostic significance of PDW for in-stent restenosis （ISR） in patients with CAD and T2DM. We aimed to determine the value of PDW on admission that predicted ISR in patients with CAD and T2DM. Methods： Between January 2012 and December 2013, a total of 5232 consecutive patients diagnosed with CAD and T2DM undergoing percutaneous coronary intervention were admitted. Three years of retrospective tbllow-up was undertaken. A total of 438 patients with second angiography operations were included. ISR was defined as ≥50% luminal stenosis of the stent or peri-stent segments. Continuous data were presented as the mean ± standard deviation or median （P25, P75） and were compared by one-way analysis of variance or Kruskal-Wallis H-test. Categorical variables were presented as percentages and were compared by Chi-square test or Fisher＇s exact test. The association between PDW and ISR was calculated by logistic regression analysis. A two-sided value of P 〈 0.05 was considered statistically significant. Statistical analyses were pertbrmed by SPSS version 22.0 for windows. Results： Fifty-nine patients with ISR, accounting for 13.5% of the total, were included. ISR was significantly more frequent in patients with higher PDW quartiles compared with lower quartiles. We observed that PDW had a strong relationship with mean platelet volume （r=0.6474 95% confidence interval [CI]： 0.535-0.750, P 〈 0.0001 ）. The receiver-operating characteristic curves showed that the PDW cutoffvalue for predicting ISR rate was 13.65 fl with sensitivity of 59.3% and specificity of 72.4% （area under curve [AUC] = 0.701,95% CI： 0.625-0.777, P 〈 0.001 ）. Multivariate analysis showed that the risk of ISR increased approximately 30% when PDW increased one u

关键词： Blood Platelet coronary restenosis Mean Platelet Volume Percutaneous coronary Intervention

Diagnostic accuracy and its affecting factors of dual-source CT for assessment of coronary stents patency and in-stent restenosis

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Chinese Medical Journal 2012年第11期125卷 1936-1940页

作者： ZHANG Xing-hua YANG Li WU Jian JU Hai-yue ZHANG Fan HE Bin CHEN Yun-dai Department of Radiology People＇s Liberation Army General Hospital Beijing 100853 China Department of Cardiology People＇s Liberation Army General Hospital Beijing 100853 China

Background In-stent restenosis is a common complication after stent implantation. However, the assessment of stent lumen in computed tomography （CT） coronary angiography is limited by multiple factors. Our study aimed to evaluate the accuracy and the suspected affecting factors in diagnosing coronary in-stent restenosis by dual-source CT （DSCT） compared with coronary angiography. Methods One hundred and fifteen stents in 50 patients were evaluated with DSCT before coronary angiography for the detection of coronary in-stent restenosis （〉 50% luminal narrowing）. Patency of each stent was analyzed by two independent expert radiologists blinded to the results of coronary angiography. The relationship between diagnostic accuracy and the suspected factors including age, body mass index （BMI）, heart rate, variation of heart rate, radiation dose, image quality, location and stent characteristics （type, material, diameter, length and strut thickness） was assessed with both univariate and multivariate analysis. The fitting of a Logistic regression model was evaluated using a receiver operating characteristic （ROC） curve. Results Mean stent diameter was （2.9±0.4） mm. Sensitivity, specificity, positive and negative predictive values and accuracy of DSCT in detection of in-stent restenosis were 69.2%, 91.2%, 50.0%, 95.9%, and 88.7%, respectively. In a subgroup of stents with a diameter 〉3.0 mm, sensitivity, specificity, positive and negative predictive values and accuracy were 100.0%, 96.5%, 75.0%, 100.0%, and 96.8%, respectively. Stent diameter 〈3.0 mm and poor image quality were associated with poor diagnostic accuracy （P 〈0.05）. The area under curve of ROC was 0.79. Conclusion DSCT can provide high accuracy for the assessment of in-stent restenosis in stents with a diameter 〉3.0 mm, and can play an important role in ruling out in-stent restenosis.

关键词： tomography, X-Ray computed, stents coronary restenosis coronary angiography

Comparison of drug-eluting stent and bare-mental stent in the complex small vessel intervention

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Chinese Medical Journal 2006年第7期119卷 596-600页

作者： QIAO Shu-bin HOU Qing XU Bo CHEN Jue LIU Hai-bo YANG Yue-jin WU Yong-jian YUAN Jin-qing WU Yuan DAI Jun YOU Shi-jie ZHANG Pei GAO Zhan DOU Ke-fei QIU Hong MU Chao-wei LI Jian-jun CHEN Ji-lin GAO Run-lin Cardiovascular Institute and Fuwai Hospital Chinese Academy ofMedical Sciences and Peking Union Medical University Beijing100037 China

Nowadays, coronary intervention has been dramatically improved in the drug-eluting stentera. The drug-eluting stent percutaneous coronary represents the dominant intervention modality beacause it significantly reduces the restenosis rate compared with bare mental stent. Such benefit was initially demonstrated in coronary vessels 3 mm or more in diameter. However, restenosis after coronary stent implantation is influenced by vessel size and length, and stent occlusion is more frequent in small vessels.

关键词： stents coronary restenosis

In vivo distribution of c-myc antisense oligodeoxynucleotides local delivered by gelatin-coated platinum-indium stents in rabbits and its effect on apoptosis

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Chinese Medical Journal 2004年第2期17卷 258-263页

作者：张新霞崔长琮许香广胡雪松方卫华邝碧娟 Department of Cardiology Shenzhen Futian Hospital Guangdong Medical College Shenzhen 518033 China Department of Cardiology First Hospital of Xi'an Jiaotong University Xi'an 710061 China

Background Post-stenting restenosis is a significant clinical problem, involving vascular smooth muscle cells ( VSMCs) proliferation and apoptosis. It is reported that c-myc antisense oligodeoxynucleotides (ASODNs) local delivered by catheter can inhibit VSMCs proliferation. This study was designed to assess tissue distribution of c-myc ASODN local delivered using gelatin-coated platinum-iridium (R-lr) stents, and its effect on apoptosis of VSMCs.Methods Gelatin-coated Pt-lr stents that had absorbed caroboxyfluorescein-5-succimidyl ester (FAM) labeled c-myc ASODNs (550 μg per stent) were implanted into the right carotid arteries of 6 rabbits. Tissue samples were obtained at 45 minutes, 2 hours, and 6 hours. Tissue distribution of c-myc ASODNs was assessed by fluorescence microscopy. In addition, 32 rabbits were randomly divided into two groups. Rabbits in the control group (n =16) were implanted with gelatin-coated R-lr stents, and those in the treatment group (n =16) were implanted with gelatin-coated stents that had absorbed c-myc ASODNs. 7, 14, 30, or 90 days (n =4, respectively, for each group) after the stenting procedure, the stented segments were harvested, and histopathological examinations were performed to calculate neointimal area and mean neointimal thickness. The expression of c-myc was assessed using in situ hybridization (ISH) and immunohistochemical methods. Apoptotic VSMCs were detected using terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) and transmission electron microscope (TEM).Results According to fluorescence microscopic results, FAM-labeled c-myc ASODNs were concentrated in the target vessel media at the 45 minutes time point, and then dispersed to the adventitia. Morphometric analysis showed that neointimal area and mean neointimal thickness increased continuously up to 90 days after stent implantation, but that total neointimal area and mean neointimal thickness were less in the treatment gr

关键词： coronary restenosis gene therapy stents platinum-iridium alloy