Gensini Score as a Predictor for in-Stent Restenosis in Patients with Coronary Artery Disease (CAD)

Abstract

\n Background: Despite Drug-eluting stent (DES) have considerably reduced the rates of in-stent restenosis (ISR). ISR is still the most common limitation of percutaneous coronary intervention（PCI). The aim of this study was to investigate potential predictors on ISR in patients with DES implantation for Coronary heart disease (CAD).Methods: A retrospective case-control study was conducted. A total of 916 patients who underwented DESs implantations and angiography follow-up within one year at the First Affiliated hospital of Xinjiang medical University, between September, 2013, and September, 2016, were included. The subjects were divided into 2 groups, ISR (n=315) and non-ISR (n=601), ISR was defined as a diameter stenosis of ≥50% located within a coronary stent or up to 5 mm beyond the stent edges. Clinical data and angiographic characteristics were collected. CAD severity was evaluated by calculating the Gensini score. The logistic regression and ROC analysis were pereformed to screen out efficient predictors.Results: Comparation between the ISR group and the non-ISR group, Gensini Score, diastolic pressure, waist, blood glucose, left ventricular end diastolic diameter (LVED), left ventricular end systolic diameter (LVES) levels were higher in ISR group, and ApoA1, ejection fraction (EF%), and accidence of myocardial infarction (MI) were lower in the ISR group. Comparation of angiographic characteristics between the groups, the results showed the occurrence of stenosis in vessels of left main coronary artery (LM), left anterior descending artery(LAD), or right coronary artery (RCA) have more vulnerability to ISR. Patients in the ISR group have been implanted more stents. In univariate regression analysis, diastolic pressure, waist, history of MI, ApoA1, number of implanted stents, and Gensini Score were associated with ISR. After multiple logistic regression analysis, Gensini score was screen out to be an independent risk factor of ISR. Receiver operating characteristic curve analysis identified that the Gensini score was a reliable predictor for ISR, area under curve (AUC): 0.80 (0.78-0.83), Sensitivity and specificity were 73.33% and 72.33%, respectively.Conclusions: Gensini score was independently associated with ISR, and was a good predictor for ISR in patients with DES implantaion.