冠状动脉内光学相干断层成像特征与稳定型冠心病患者PCI术后支架内再狭窄风险的相关性OACSTPCD

Objective To explore the correlation between the characteristics of optical coherence tomography(OCT)in coronary artery and the risk of in-stent restenosis(ISR)in patients with stable coronary heart disease after percutaneous coronary intervention(PCI).Methods A retrospective analysis was conducted,including 100 patients with stable coronary heart disease who underwent PCI in Qingdao Cardiovascular Disease Hospital from August 2021 to December 2023 as the research object,and one-year follow-up was completed.According to the occurrence of ISR within one year after PCI,patients were divided into the ISR group(50 cases)and the non-ISR group(50 cases).Clinical data and OCT characteristics of coronary artery were compared between the two groups.The influencing factors of ISR after PCI were analyzed by multivariate Logistic regression analysis.The predictive efficacy of the influencing factors on ISR after PCI was further analyzed by plotting receiver operating characteristic(ROC)curves.Results The dosage of statins in the ISR group was lower than that in the non-ISR group,while the cholesterol and low-density lipoprotein cholesterol(LDL-C)levels were higher than those in the non-ISR group,and the mininmum lumen diameter(MLD)in the ISR group was smaller than that in the non-ISR group(t=11.596,5.562,8.498,10.185;P<0.05).The lumen area and neointimal load in the ISR group were higher than those in the non-ISR group,and the proportions of heterogeneous intima,lipid plaques,and calcification were also higher in the ISR group(t/χ2=10.248,3.581,9.180,5.769,7.440;P<0.05).Multivariate Logistic regression analysis showed that dosage of statins as a protective factor of ISR in patients with stable coronary heart disease after PCI(OR=0.612,P<0.05),while LDL-C,neointimal load,heterogeneous intima,and calcification were risk factors for ISR(OR=13.635,4.953,14.000,12.667;P<0.05).ROC curve analysis showed that the area under the curve(AUC)for dosage of statins was 0.833,and the optimal cutoff value was 18.34 mg/d;the AUC for LDL-C was 0.849,and the optimal cutoff value was 2.01 mmol/L;the AUC of neointimal load was 0.908,and the optimal cutoff value was 48.96%,the sensitivity and specificity were 90.00%and 82.00%,respectively.Conclusion The dosage of statins,LDL-C,and neointimal load have good predictive value for ISR in patients with stable coronary heart disease after PCI.Neointimal load,as one of OCT features,can be used as effective indicators to evaluate the risk of ISR in patients with stable coronary heart disease after PCI.