# Inflammatory Prognostic Index: A Novel Predictor of In-Stent Restenosis Following Drug-Eluting Stent–Percutaneous Coronary Intervention

## TL;DR

This study shows that the Inflammatory Prognostic Index (IPI), based on routine blood tests, can predict in-stent restenosis after heart stent procedures.

## Contribution

The study introduces IPI as a novel, inexpensive biomarker for predicting in-stent restenosis after drug-eluting stent implantation.

## Key findings

- ISR occurred in 38.1% of patients after DES implantation.
- Elevated IPI independently predicted ISR with an odds ratio of 2.90.
- The optimal IPI cutoff for predicting ISR was 1.275 with 84.4% sensitivity and 74.5% specificity.

## Abstract

Background: The Inflammatory Prognostic Index (IPI) is a novel biomarker integrating C-reactive protein (CRP), albumin, and white blood cell-derived ratios, reflecting systemic inflammation and nutritional status. Inflammation is central to in-stent restenosis (ISR). This study investigated the prognostic value of IPI in predicting ISR after drug-eluting stent (DES) implantation. Methods: We retrospectively analyzed 571 patients who underwent DES implantation and follow-up angiography at a median of 12 months (IQR 12–24) for recurrent angina or ischemia. Patients were grouped as ISR (+) (n = 218) and ISR (−) (n = 353). IPI was calculated as (CRP × neutrophil-to-lymphocyte ratio)/albumin. Logistic regression and ROC analyses assessed the predictive role of IPI. Results: ISR occurred in 38.1% of patients. The ISR (+) group showed a higher prevalence of hypertension and active smoking, as well as higher CRP, glucose, and neutrophil levels, but lower albumin and lymphocytes (all p < 0.05). Elevated IPI independently predicted ISR (OR = 2.90; 95% CI = 2.35–3.57; p < 0.001). ROC analysis showed an optimal cutoff of 1.275 (sensitivity 84.4%, specificity 74.5%). Conclusions: IPI, derived from routine laboratory tests, independently predicts ISR after DES implantation and may serve as a simple, inexpensive biomarker for coronary artery disease risk stratification.