Cholesterol, high-density lipoprotein, glucose index as a novel marker for predicting in-stent restenosis after drug-eluting stent implantation in patients with acute coronary syndrome

TL;DR

A new metabolic marker called CHG index is linked to a higher risk of in-stent restenosis in patients with acute coronary syndrome who receive drug-eluting stents.

Contribution

The study identifies the CHG index as a novel predictor of in-stent restenosis after drug-eluting stent implantation in ACS patients.

Findings

A higher CHG index was associated with increased odds of in-stent restenosis.

The association between CHG index and restenosis risk was linear and statistically significant.

Patients in the highest tertile of CHG index had over twice the odds of restenosis compared to the lowest tertile.

Abstract

Acute coronary syndrome (ACS) poses a serious health risk, and drug-eluting stent (DES) implantation is widely used to improve prognosis. However, the risk of in-stent restenosis (ISR) persists in some patients. The CHG index, a novel metabolic marker, has not been clearly linked to ISR risk in ACS patients undergoing DES-based percutaneous coronary intervention (PCI).

This retrospective study enrolled ACS patients who underwent PCI with successful DES implantation from June 2015 to July 2021 and and underwent coronary angiography at 6 to 24 months after successful DES-based PCI. Patients were stratified into tertiles based on CHG index. Logistic regression analysis models were used to evaluate the independent association between CHG index and ISR. Restricted cubic spline (RCS) models were used to examine potential nonlinear relationships, and subgroup analyses explored possible effect modifiers.

A total of 454 patients with ACS were included. In the fully adjusted model, CHG index was positively associated with DES-ISR incidence (per 1-unit increase, odds ratio [OR] = 2.61, 95% confidence interval [CI] 1.28–5.33, P = 0.008). Compared to the lowest tertile, the ORs (95% CI) for the second and third tertiles were 2.33 (1.12–4.85, P = 0.024) and 2.40 (1.05–5.49, P = 0.038), respectively. Furthermore, a linear positive association was observed between CHG index and risk of ISR post-PCI (overall P = 0.016; nonlinear P = 0.118).

For ACS patients treated with DES-PCI, a high CHG index was found to be significantly and linearly associated with an increased risk of DES-ISR.

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