Prediction of risk for in-stent coronary restenosis in patients with obesity
Veselovskaya N.G., Chumakova G.A., Ott A.V., Gritsenko O.V., Subbotin E.A.
Keywords: CAD, obesity, restenosis, transcutaneous coronary intervention
Background. Transcutaneous coronary intervention (TCI) with stent placement is an effective treatment for IHD. However the restenosis incidence ranges from 12 to 40 %. Aim. Evaluating the predictive value of epicardial obesity and metabolic factors for the risk of in-stent coronary restenosis in patients with IHD. Materials and methods. The study included 186 males (age 54.4±9.1 years) with IHD and BMI ≥30 kg / m² (34.23±3.97 kg / m²) in the period of their scheduled preparation for TCI with stent placement. Prospective observation was performed for one year after TCI. Laboratory tests for major and emerging metabolic RFs and echoCG with measurement of epicardial adipose tissue thickness (EATT) were performed for all patients. Coronary restenosis was defined as a luminal narrowing of ≥50 % in the site of intervention. Results. Restenosis was found in 17.3 % (n=32) of cases. As estimated using the logistic regression equation, the most significant set of restenosis predictors with a high rate of correct prediction (81.5 %) included leptin, lipoprotein (a), EATT, glucose, interleukin-6, and HDLP cholesterol. Area under the ROC curve was 0.8150, which indicated a high quality of the obtained mathematical model. Conclusion. The obtained set of predictors allows selecting the most promising and efficient programs of multimodal drug and non-drug preoperative preparation for myocardial revascularization in patients with obesity.
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Veselovskaya N.G., Chumakova G.A., Ott A.V. et al. Prediction of risk for in-stent coronary restenosis in patients with obesity. Russian Heart Journal. 2013;12(5):305-310