Objective:Numerous studies have suggested that C1q/tumor necrosis factor-related protein 9(CTRP9)is closely associated with the risk of cardiovascular disease.This study aims to explore the association between serum CTRP9 and in stent restenosis(ISR).Methods:This study retrospectively included patients with acute coronary syndrome(ACS)who were implanted with drug-eluting stents(DES)in our hospital from January 2019 to December 2023 and underwent intravascular ultrasound examination at 22-26 months after intervention.Based on the evaluation results,the included population will be divided into a DES-ISR group and a non-DES-ISR group.Subsequently,the association between CTRP9 and DES-ISR was evaluated using a multiple regression analysis model.Results:This study included a total of 135 ACS patients,including 50 DES-ISR patients.Compared with the non DES-ISR group,the CTRP9 concentration level in the DES-ISR group was significantly lower[(5.4±1.9)vs.(6.7±2.0)μg/L,P<0.001].In univariate regression analysis,CTRP9 was significantly correlated with DES-ISR(OR=0.691,95%CI:0.562-0.849,P<0.001);After adjusting for other confounding factors through a multiple regression analysis model,CTRP9 remained independently correlated with DES-ISR(OR=0.706,95%CI:0.559-0.892,P=0.002).Conclusions:Through this observational study,it has been confirmed that CTRP9 is independently associated with the mid to long-term DES-ISR risk in ACS patients.