Correlation and clinical significance of calcium channel blocker therapy for in-stent restenosis after percutaneous coronary intervention

Abstract

Background In-stent restenosis (ISR) is one of major complications after percutaneous coronary intervention (PCI) in patients with coronary artery disease(CAD). The prevention and treatment of ISR is not well established yet. This study explored the correlation and clinical significance of calcium channel blockers(CCB) and ISR . Methods Patients who received coronary angiography(CAG) after PCI in Department of Cardiology, The Third Clinical Medical College of Shanxi Medical University from November 2019 to April 2022 were collected, and the relationship between calcium channel blockers taken by patients before PCI and the occurrence time of in-stent restenosis as well as the severity of restenosis was analyzed. Chi-square test or t test, pearson correlation regression analysis and logistic regression analysis were conducted . Results The in-stent restenosis group (ISR group) and the non-stent restenosis group (no-ISR group) had significant differences in diabetes, previous myocardial infarction history, red blood cell distribution width, fasting blood glucose, ACC/AHA lesion classification, stent maximum diameter, total stent length, and stent expansion pressure (all P < 0.05). Patients with ISR had higher levels of total cholesterol, triglycerides, homocysteine(Hcy) and D- dimer in the preoperative oral calcium channel blocker group (CCBs group) than in the non-oral calcium channel blocker group (no-CCBs group). Moreover, the maximum balloon dilatation pressure and the degree of ISR in the CCBs group were lower, and the time interval for ISR was longer (all P < 0.05). Among the ISR patients with Hcy ≥ 10µmol/L, the no-CCBs group had lower levels of peripheral blood total cholesterol, triglycerides, Hcy and D-dimer, larger maximum balloon dilatation pressure and ISR, and a shorter time interval for ISR (P < 0.05). Conclusion The use of CCB has a direct correlation with the incidence, interval and severity of ISR. The use of CCB may delay the occurrence time of in-stent restenosis after PCI in patients, providing new ideas for the prevention and treatment strategies of ISR.