# The Relationship Between Serum SFRP5, ApoA‐I, HDL3‐C Level and In‐Stent Restenosis After PCI in Acute Myocardial Infarction and the Combined Predictive Value

## TL;DR

This study finds that higher levels of SFRP5, ApoA-I, and HDL3-C are linked to lower risk of in-stent restenosis after heart procedures in AMI patients.

## Contribution

The study identifies a novel combined predictive value of SFRP5, ApoA-I, and HDL3-C for in-stent restenosis after PCI in AMI patients.

## Key findings

- Higher SFRP5, ApoA-I, and HDL3-C levels are protective against in-stent restenosis after PCI.
- Diabetes and elevated hs-CRP are risk factors for in-stent restenosis.
- Combining SFRP5, ApoA-I, and HDL3-C improves predictive accuracy for in-stent restenosis.

## Abstract

This study aims to investigate the relationship between serum secreted frizzled‐related protein 5 (SFRP5), apolipoprotein A‐I (ApoA‐I), high‐density lipoprotein 3‐cholesterol (HDL3‐C) and in‐stent restenosis (ISR) after percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) and their combined predictive value. The clinical data of 128 AMI patients who underwent PCI in our hospital from July 2020 to July 2023 were retrospectively analyzed. After 12 months of follow‐up, the patients were divided into the ISR group (24 cases) and the non‐ISR group (104 cases) according to the results of coronary angiography. The 24 patients with ISR were divided into Grade III (lumen stenosis area of 50%–70%, 15 cases) and Grade IV (lumen stenosis area of 76%–100%, 9 cases). The general data of the two groups were compared. The serum levels of SFRP5, ApoA‐I, and HDL3‐C in the two groups were analyzed on the second day after the operation. The levels of SFRP5, ApoA‐I, and HDL3‐C in patients with different degrees of stenosis were compared. The correlation between serum SFRP5, ApoA‐I, HDL3‐C levels and ISR after PCI was analyzed by bivariate correlation Kendall tau‐b (K). Logistic regression was used to analyze the influencing factors of ISR after PCI. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of SFRP5, ApoA‐I, and HDL3‐C in ISR after PCI. The proportion of patients with diabetes and a smoking history in the ISR group was higher than that in the non‐ISR group. The stent length (29.52 ± 5.47 mm) and hs‐CRP level (3.38 ± 0.51 mg/L) in the ISR group were higher than those in the non‐ISR group (23.56 ± 5.37 mm and 2.78 ± 0.52 mg/L) (p < 0.05). SFRP5 (15.33 ± 2.60 ng/mL), ApoA‐I (1.22 ± 0.37 g/L) and HDL3‐C (0.31 ± 0.07 mmol/L) in the ISR group were higher than those in the non‐ISR group (19.79 ± 3.09 ng/mL, 1.77 ± 0.41 g/L, and 0.46 ± 0.11 mmol/L) (p < 0.001). The levels of SFRP5 (17.57 ± 2.57 ng/mL), ApoA‐I (1.56 ± 0.34 g/L) and HDL3‐C (0.36 ± 0.07 mmol/L) in the Grade III group were higher than those in the Grade IV group (13.15 ± 2.35 ng/mL, 0.98 ± 0.20 g/L, and 0.25 ± 0.05 mmol/L) (p < 0.05). The results of bivariate correlation Kendall tau‐b (K) analysis showed that the levels of serum SFRP5, ApoA‐I, and HDL3‐C were negatively correlated with ISR (r < 0, p < 0.05). Logistic regression analysis showed that diabetes and hs‐CRP were risk factors for ISR after PCI (OR > 1, p < 0.05). SFRP5, ApoA‐I, and HDL3‐C were protective factors for ISR after PCI (OR < 1, p < 0.05). The ROC curve showed that the AUC of SFRP5, ApoA‐I, and HDL3‐C levels alone and in combination to predict ISR in AMI patients after PCI was > 0.70, which had certain predictive value, and the combined value was higher. In conclusion, diabetes and high levels of hs‐CRP were risk factors for ISR in patients with AMI after PCI. High levels of SFRP5, ApoA‐I, and HDL3‐C were protective factors for ISR after PCI, and their combined detection had certain value in predicting ISR after PCI. This would provide guidance strategy for clinical timely intervention measures to reduce the occurrence of ISR in AMI patients after PCI.