Is In-Stent Restenosis After a Successful Coronary Stent Implantation Due to Stable Angina Associated With TG/HDL-C Ratio?

Abstract

We examined the impact of the preprocedural triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio on risk of in-stent restenosis (ISR). Patients with typical anginal symptoms and/or positive treadmill or myocardial perfusion scintigraphy test results who underwent successful coronary stent implantation due to stable angina were examined; 1341 patients were enrolled. The hospital files of the patients were used to gather data. Cox regression analysis showed that the TG/HDL-C ratio was independently associated with the presence of ISR ( P < .001). Moreover, diabetes mellitus ( P = .007), smaller stent diameter ( P = .046), and smoking status ( P = .001) were also independently associated with the presence of ISR. Using a cutoff of 3.8, the TG/HDL-C ratio predicted the presence of ISR with a sensitivity of 71% and a specificity of 68%. Also, the highest quartile of TG/HDL-C ratio had the highest rate of ISR ( P < .001). Measuring preprocedural TG/HDL-C ratio, in fasting or nonfasting samples, could be beneficial for the risk assessment of ISR. However, further large-scale prospective studies are required to establish the exact role of this simple, easily calculated, and reproducible parameter in the pathogenesis of ISR.

Predictors of In-Stent Restenosis in Patients With Stable Angina Pectoris

“…We read with interest the article entitled "Is ln-Stent Restenosis After a Successful Coronary Stent Implantation Due to Stable Angina Associated With TG/HDL-C Ratio?" by Kundi et al 1 They reported a significant association between triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio and in-stent restenosis (ISR). 1 Despite major advances in interventional techniques and drug therapy, ISR remains a major problem in interventional cardiology.…”

“…by Kundi et al 1 They reported a significant association between triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio and in-stent restenosis (ISR). 1 Despite major advances in interventional techniques and drug therapy, ISR remains a major problem in interventional cardiology. Several inflammatory biomarkers have been investigated in the setting of coronary stenting to stratify the risk of both angiographic and clinical outcomes.…”

“…[3][4][5][6] In the study by Kundi et al, it was clear that the white blood cell count was higher, whereas neutrophil and lymphocyte count were lower in the ISR (þ) group when compared to the ISR (À) group ( Table 2). 1 Then, we could estimate that the monocyte count is higher in the ISR (þ) group. In addition, the MHR was also more likely higher in the ISR (þ) group since HDL-C was lower in the ISR (þ) group.…”

“…However, the authors did not report these parameters. 1 It would be useful if the authors provided CRP, MHR, and resting heart rate values of their study population. 1 Besides, they did not include these possible confounding factors in Cox regression analysis.…”

“…1 It would be useful if the authors provided CRP, MHR, and resting heart rate values of their study population. 1 Besides, they did not include these possible confounding factors in Cox regression analysis. Another question about the study 1 is that, as the authors mentioned as limitations, TG levels of some patients were calculated from nonfasting blood samples.…”