Impact of free thyroxine levels and other clinical factors on bare metal stent restenosis

Canpolat, Uğur; Turak, Osman; Özcan, Fırat; Öksüz, Fatih; Mendi, Mehmet Ali; Yayla, Çağrı; Aydoğdu, Sinan

doi:10.1590/2359-3997000000197

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…To this effect, computed tomography angiography findings of patients with overt and subclinical hyperthyroidism had revealed a greater extent of high-grade and overall coronary stenoses, plaque burden, and high-risk plaque hallmarks than the euthyroid patients [12]. The data from Canpolat et al substantiate this point, whereby the preprocedural serum level of fT4 was found to be a significant independent factor of ISR in patients with successful BMS implants [13].…”

Section: Discussionmentioning

confidence: 95%

Early Restenosis of Sirolimus-eluting Stent: An Unusual Case of a Hyperthyroid Patient

Shabbir¹,

Baloch²,

Mustafa³

et al. 2019

Cureus

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The presentation of atherosclerosis with concomitant hyperthyroidism is not uncommon. Hyperthyroidism predisposes to worse cardiovascular pathologies like systolic hypertension, atrial fibrillation, and hypercoagulability. Drug-eluting stents, on the other hand, have emerged as a miracle treatment choice for patients having atherogenic conditions. They have the highest success rates when it comes to minimizing in-stent restenosis (ISR) during shortterm follow-up. There is scarce literature that assesses the correlation of multinodular goiter (MNG) to ISR, especially in Pakistan, and thus any probable association between the two is left untouched. We report a case of a 57-year-old female who is a known hyperthyroid with a massive MNG, presenting with worsening chest pain. She had undergone sirolimus-eluting stent (SES) implantation in left anterior descending artery (LAD) six months back. Cardiac catheterization confirmed restenosis of the SES in the LAD, along with the occlusion of left circumflex and right coronary artery, accompanied by grade I diastolic dysfunction and mild aortic regurgitation on echocardiography.

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Section: Discussionmentioning

confidence: 95%

Early Restenosis of Sirolimus-eluting Stent: An Unusual Case of a Hyperthyroid Patient

Shabbir¹,

Baloch²,

Mustafa³

et al. 2019

Cureus

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“…Only Canpolat et al found that high preoperative serum FT4 level was an effective independent predictor of BMS restenosis in patients with stable and unstable angina pectoris. They suggested that serum FT4 increases the risk of ISR by enhancing the activity of the renin-angiotensin system and the proliferation of vascular smooth muscle cells ( 38 ). Therefore, this study is the first to identify thyroxine as a significant predictor of ISR after drug-eluting stent implantation.…”

Section: Discussionmentioning

confidence: 99%

Risk investigation of in-stent restenosis after initial implantation of intracoronary drug-eluting stent in patients with coronary heart disease

Huang

Liu

Tao

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveTo analyze the risk factors of in-stent restenosis (ISR) after the first implantation of drug-eluting stent (DES) patients with coronary heart disease (CHD) and to establish a nomogram model to predict the risk of ISR.MethodsThis study retrospectively analyzed the clinical data of patients with CHD who underwent DES treatment for the first time at the Fourth Affiliated Hospital of Zhejiang University School of Medicine from January 2016 to June 2020. Patients were divided into an ISR group and a non-ISR (N-ISR) group according to the results of coronary angiography. The least absolute shrinkage and selection operator (LASSO) regression analysis was performed on the clinical variables to screen out the characteristic variables. Then we constructed the nomogram prediction model using conditional multivariate logistic regression analysis combined with the clinical variables selected in the LASSO regression analysis. Finally, the decision curve analysis, clinical impact curve, area under the receiver operating characteristic curve, and calibration curve were used to evaluate the nomogram prediction model's clinical applicability, validity, discrimination, and consistency. And we double-validate the prediction model using ten-fold cross-validation and bootstrap validation.ResultsIn this study, hypertension, HbA1c, mean stent diameter, total stent length, thyroxine, and fibrinogen were all predictive factors for ISR. We successfully constructed a nomogram prediction model using these variables to quantify the risk of ISR. The AUC value of the nomogram prediction model was 0.806 (95%CI: 0.739–0.873), indicating that the model had a good discriminative ability for ISR. The high quality of the calibration curve of the model demonstrated the strong consistency of the model. Moreover, the DCA and CIC curve showed the model's high clinical applicability and effectiveness.ConclusionsHypertension, HbA1c, mean stent diameter, total stent length, thyroxine, and fibrinogen are important predictors for ISR. The nomogram prediction model can better identify the high-risk population of ISR and provide practical decision-making information for the follow-up intervention in the high-risk population.

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“…In recent years, a number of studies have found a correlation between thyroid hormone and acute coronary syndrome (ACS), and low FT3 is an independent risk factor for coronary artery severity and MACE after PCI [ 17 , 18 , 19 , 20 , 21 , 22 ]. Studies have also explored the relationship between thyroxine and ISR [ 23 ]. Canpolat et al .…”

Section: Discussionmentioning

confidence: 99%

“…Canpolat et al . [ 23 ] reported that elevated plasma FT4 levels were an independent risk factor for ISR after BMS implantation, but few studies have investigated the relationship between FT3 and ISR. In this study, it was found that low FT3 was an independent risk factor for myocardial infarction, recurrent ISR, and TVR in patients with ISR after revascularization, and its mechanism may involve the following aspects.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors for Major Adverse Cardiovascular Events in Patients with Coronary Stent Restenosis after Revascularization

Yang¹,

Wang²,

Dong³

et al. 2023

Rev. Cardiovasc. Med.

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Background: To investigate the risk factors for myocardial infarction, recurrent in-stent restenosis (ISR) and target vessel revascularization (TVR) in patients with coronary ISR within 4 years after revascularization. Methods: A total of 1884 patients who were hospitalized at Fuwai Hospital for ISR and successfully treated with coronary intervention between January 2017 and December 2018 were included to determine whether there were myocardial infarction, recurrent ISR, TVR and other major adverse cardiovascular events (MACEs) within 4 years after intervention. The patients were divided into the MACE group (215 patients) and the non-MACE group (1669 patients). The clinical data of patients in the two groups were compared, and the risk factors for postoperative MACEs in the ISR patients were obtained by multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve was used to determine the optimal prediction threshold for postoperative MACEs in ISR patients. The difference in survival curves between the two groups was compared using Kaplan‒Meier survival analysis. Results: The albumin (43.42 4.77 vs. 44.17 4.46, p = 0.021), direct bilirubin (2.5 (2, 3.5) vs. 2.8 (2.07, 3.73), p = 0.036) and free triiodothyronine (FT3) (2.85 0.43 vs. 2.92 0.42, p = 0.019) levels in the MACE group were significantly lower than those in the non-MACE group, and there was a significant negative correlation between albumin and FT3 and MACEs. The results of univariate and multivariate logistic regression analyses revealed that FT3 was an independent predictor of postoperative MACEs in ISR patients (Odds Ratio (OR) = 0.626, 95% CI: 0.429–0.913, p = 0.015). The ROC curve analysis determined that an FT3 value of 2.785 pmol/L was the optimal prediction threshold. According to the threshold, ISR patients were divided into the FT3 2.785 group and the FT3 2.785 group. The Kaplan‒Meier analysis revealed that the postoperative recurrence rate of MACEs of the FT3 2.785 group was substantially greater than that of the FT3 2.785 group (Hazard Ratio (HR) = 0.76, 95% CI: 0.58–0.994, p = 0.044). Conclusions: FT3 can be used as an independent predictor of postoperative myocardial infarction, recurrent ISR and TVR in ISR patients. When FT3 is 2.785 pmol/L, the incidence of postoperative myocardial infarction, recurrent ISR and TVR in ISR patients increases significantly.

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Impact of free thyroxine levels and other clinical factors on bare metal stent restenosis

Cited by 4 publications

References 30 publications

Early Restenosis of Sirolimus-eluting Stent: An Unusual Case of a Hyperthyroid Patient

Early Restenosis of Sirolimus-eluting Stent: An Unusual Case of a Hyperthyroid Patient

Risk investigation of in-stent restenosis after initial implantation of intracoronary drug-eluting stent in patients with coronary heart disease

Analysis of Risk Factors for Major Adverse Cardiovascular Events in Patients with Coronary Stent Restenosis after Revascularization

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