Expression and clinical significance of cystatin C,tissue inhibitor of metalloproteinase-1 and secreted frizzled-related protein5 in elderly patients with in-stent restenosis after percutaneous coronary intervention
Objective To investigate the expression of cystatin C(CysC),tissue inhibitor of metalloproteinase-1(TIMP-1)and secreted frizzled-related protein5(SFRP-5)in elderly patients with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)and its predictive value for target vessel lesions.Methods A total of 65 elderly patients with coronary heart disease(CHD)who developed ISR within 1 year after PCI in Baoding First Central Hospital from May 2020 to May 2022 were selected as the observation group,and 65 elderly CHD patients in the same period without ISR within 1 year after PCI were selected as the control group.The general information,postoperative serum CysC,TIMP-1 and SFRP-5 levels of the two groups were compared,and the correlation between serum CysC,TIMP-1 and SFRP-5 levels and the occurrence of ISR was analyzed.The serum CysC,TIMP-1 and SFRP-5 levels of patients with different Mehran subtypes in the observation group were compared,and the correlation between each index level and Mehran subtype was analyzed.The value of serum CysC,TIMP-1 and SFRP-5 levels in predicting the occurrence of ISR in the target vessel was evaluated.Results Serum CysC level in the observation group was higher than that in the control group(t=6.949,P<0.05),while TIMP-1 and SFRP-5 levels were lower than those in the control group(t=7.301,8.765;P<0.05).Serum CysC level was positively correlated with the occurrence of ISR(r=0.587,P<0.05),while TIMP-1 and SFRP-5 levels were negatively correlated with the occurrence of ISR(r=-0.609,-0.640;P<0.05).Differences in the serum levels of CysC,TIMP-1 and SFRP-5 among the four Mehran subtypes in the observation group were statistically significant(F=10.759,8.326,19.764;P<0.05).As the Mehran suptype changed from typeⅠto typeⅣ,the level of CysC gradually increased,while the levels of TIMP-1 and SFRP-5 gradually decreased,with significant differences(P<0.05).Serum CysC level was positively correlated with the Mehran subtype of ISR patients(r=0.722,P<0.05),while TIMP-1 and SFRP-5 levels were negatively correlated with Mehran subtype(r=-0.799,-0.826;P<0.05).The area under the curve(AUC)values for predicting the occurence of ISR in elderly patients with CHD after PCI within 1 year using serum levels of CysC,TIMP-1 and SFRP-5 were 0.807(95%CI=0.729-0.871),0.786(95%CI=0.706-0.853),and 0.811(95%CI=0.733-0.874),respectively.The combined prediction had the largest AUC value of 0.943(95%CI=0.887-0.976).Conclusion Elevated serum CysC level and decreased TIMP-1 and SFRP-5 levels in elderly CHD patients after PCI were found to be associated with the development of ISR.Serum levels of these indicators in the early postoperative period can be used to predict the risk of ISR in the target vessel.
Coronary heart diseasePercutaneous coronary interventionIn-stent restenosisCystatin CTissue inhibitor of metalloproteinase-1Secreted frizzled-related protein 5
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