Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention
Aim. To study the relationship between plasma levels of lipoprotein(a) (Lp(a)), vascular endothelial growth factor (VEGF), transforming growth factor β (TGF-β), and the occurrence of stent restenosis after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD), as we...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Столичная издательская компания
2025-06-01
|
| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/3177 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849227481307938816 |
|---|---|
| author | M. А. Meshkova I. A. Starodubtseva A. A. Pashkova |
| author_facet | M. А. Meshkova I. A. Starodubtseva A. A. Pashkova |
| author_sort | M. А. Meshkova |
| collection | DOAJ |
| description | Aim. To study the relationship between plasma levels of lipoprotein(a) (Lp(a)), vascular endothelial growth factor (VEGF), transforming growth factor β (TGF-β), and the occurrence of stent restenosis after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD), as well as the achievement of target low-density lipoprotein cholesterol level with lipid-lowering therapy.Material and methods. The prospective study included 92 patients (mean age 64.0 years, 79.5% male, 20.5% female) diagnosed with acute coronary syndrome (ACS) who underwent stenting of a clinically significant or infarction-related coronary artery. At the same time, blood flow in the remaining coronary arteries was visually assessed during selective coronary angiography (SCA). In cases of hemodynamically significant stenosis of a coronary artery not associated with ACS, ranging from 70% to 90%, the patient was invited to consult a cardiologist in a month to decide on myocardial revascularization through stress testing, taking into account the patient’s clinical status (complaints). If necessary, repeat SCA for therapeutic purposes was performed after 1-2 months to visualize neointima formation and the degree of restenosis within the stent previously implanted in the infarct-related artery, in combination with the determination of Lp(a), VEGF, and TGF-β in blood plasma. The achievement of the target LDL-C level against the background of lipid-lowering therapy was assessed. Patients were divided into 2 groups: with detected restenosis or neointima (n=49) and without restenosis (n=43). The clinical, laboratory, and angiographic data obtained in the groups were compared.Results. The development of restenosis is associated with a prolonged course of CAD — 6.0 (4.0; 11.0) months (p<0.001), stable CAD was recorded in 42.86% (p=0.01), chronic kidney disease (CKD) 3A 32.65% (p=0.02) and the use of bare-metal stent (BMS) was 79.59% (n=39) (p<0.001), Lp(a) level >30 mg/dL 36.73% (p=0.01). Analysis of combinations revealed that having both TGF-β and Lp(a) within normal ranges simultaneously was a protective factor against restenosis development (odds ratio=0.2 [95% confidential interval: 0.07-0.56]), as was having both Lp(a) and VEGF within normal ranges (odds ratio=0.33 [95% confidential interval: 0.14-0.82]). Conclusion. In CAD patients 1-2 months post-PCI for ACS, restenosis development is associated with longer CAD duration, CKD stage 3A, use of BMS, and elevated Lp(a) levels >30 mg/dL, irrespective of achieving the target LDL-C level <1.4 mmol/L. Elevated baseline Lp(a) values combined with VEGF and TGF-β levels in blood plasma indicates a high risk of stent restenosis, which may be new biomarkers for predicting the progression of coronary artery disease. These results confirm the need to develop practical guidelines for the dynamic monitoring of this patient group. |
| format | Article |
| id | doaj-art-15ae67804af54b198b6e7794d80bb387 |
| institution | Kabale University |
| issn | 1819-6446 2225-3653 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj-art-15ae67804af54b198b6e7794d80bb3872025-08-23T10:00:37ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532025-06-0121213214210.20996/1819-6446-2025-31772283Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary interventionM. А. Meshkova0I. A. Starodubtseva1A. A. Pashkova2N. N. Burdenko Voronezh State Medical UniversityN. N. Burdenko Voronezh State Medical UniversityN. N. Burdenko Voronezh State Medical UniversityAim. To study the relationship between plasma levels of lipoprotein(a) (Lp(a)), vascular endothelial growth factor (VEGF), transforming growth factor β (TGF-β), and the occurrence of stent restenosis after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD), as well as the achievement of target low-density lipoprotein cholesterol level with lipid-lowering therapy.Material and methods. The prospective study included 92 patients (mean age 64.0 years, 79.5% male, 20.5% female) diagnosed with acute coronary syndrome (ACS) who underwent stenting of a clinically significant or infarction-related coronary artery. At the same time, blood flow in the remaining coronary arteries was visually assessed during selective coronary angiography (SCA). In cases of hemodynamically significant stenosis of a coronary artery not associated with ACS, ranging from 70% to 90%, the patient was invited to consult a cardiologist in a month to decide on myocardial revascularization through stress testing, taking into account the patient’s clinical status (complaints). If necessary, repeat SCA for therapeutic purposes was performed after 1-2 months to visualize neointima formation and the degree of restenosis within the stent previously implanted in the infarct-related artery, in combination with the determination of Lp(a), VEGF, and TGF-β in blood plasma. The achievement of the target LDL-C level against the background of lipid-lowering therapy was assessed. Patients were divided into 2 groups: with detected restenosis or neointima (n=49) and without restenosis (n=43). The clinical, laboratory, and angiographic data obtained in the groups were compared.Results. The development of restenosis is associated with a prolonged course of CAD — 6.0 (4.0; 11.0) months (p<0.001), stable CAD was recorded in 42.86% (p=0.01), chronic kidney disease (CKD) 3A 32.65% (p=0.02) and the use of bare-metal stent (BMS) was 79.59% (n=39) (p<0.001), Lp(a) level >30 mg/dL 36.73% (p=0.01). Analysis of combinations revealed that having both TGF-β and Lp(a) within normal ranges simultaneously was a protective factor against restenosis development (odds ratio=0.2 [95% confidential interval: 0.07-0.56]), as was having both Lp(a) and VEGF within normal ranges (odds ratio=0.33 [95% confidential interval: 0.14-0.82]). Conclusion. In CAD patients 1-2 months post-PCI for ACS, restenosis development is associated with longer CAD duration, CKD stage 3A, use of BMS, and elevated Lp(a) levels >30 mg/dL, irrespective of achieving the target LDL-C level <1.4 mmol/L. Elevated baseline Lp(a) values combined with VEGF and TGF-β levels in blood plasma indicates a high risk of stent restenosis, which may be new biomarkers for predicting the progression of coronary artery disease. These results confirm the need to develop practical guidelines for the dynamic monitoring of this patient group.https://www.rpcardio.online/jour/article/view/3177stent restenosisrisk factorscoronary artery diseasepercutaneous transluminal angioplastylipoprotein (a)vascular endothelial growth factortransforming growth factor β |
| spellingShingle | M. А. Meshkova I. A. Starodubtseva A. A. Pashkova Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention Рациональная фармакотерапия в кардиологии stent restenosis risk factors coronary artery disease percutaneous transluminal angioplasty lipoprotein (a) vascular endothelial growth factor transforming growth factor β |
| title | Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention |
| title_full | Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention |
| title_fullStr | Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention |
| title_full_unstemmed | Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention |
| title_short | Prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention |
| title_sort | prognostic factors for stent restenosis in patients with coronary artery disease undergoing percutaneous coronary intervention |
| topic | stent restenosis risk factors coronary artery disease percutaneous transluminal angioplasty lipoprotein (a) vascular endothelial growth factor transforming growth factor β |
| url | https://www.rpcardio.online/jour/article/view/3177 |
| work_keys_str_mv | AT mameshkova prognosticfactorsforstentrestenosisinpatientswithcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention AT iastarodubtseva prognosticfactorsforstentrestenosisinpatientswithcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention AT aapashkova prognosticfactorsforstentrestenosisinpatientswithcoronaryarterydiseaseundergoingpercutaneouscoronaryintervention |