Nomogram analysis of influencing factors of restenosis after drug-eluting stent implantation in diabetic patients / 中国基层医药

ABSTRACT

Objective:To investigate the influencing factors of restenosis after drug-eluting stent(DES) implantation in diabetic patients, and to establish a Nomogram graph prediction model.Methods:From January 2016 to January 2019, 78 patients with diabetes mellitus who underwent coronary DES implantation successfully in the Second People's Hospital of Nanyang were retrospectively analyzed, and the patients were followed up for 8-12 months.According to the follow-up results, the patients were divided into non-stenosis group(61 cases) and restenosis group(17 cases). Age, sex, smoking history, history of hypertension, BMI, UA, glycated hemoglobin, TG, VLDL, TC, HDL, FBG, CRP, creatinine, TB, DB, platelet count, LVEF, number of lesion vessels, location of lesion vessels, SYNTAX score and drug use were analyzed by univariate analysis.Multivariate analysis was further conducted by logistic regression.According to the results of logistic regression, the Nomogram graph was established by using R software(R 3.3.2), and the scoring prediction model was constructed.Results:Univariate analysis showed that smoking history, hypertension history, UA, HbA1c, TG, VLDL, number of lesion vessels and SYNTAX score were related to restenosis after coronary DES implantation( P<0.05). Multivariate analysis showed that the number of lesion vessels( OR=3.681, 95% CI 1.229~11.027, P=0.020), UA( OR=12.004, 95% CI 1.406~102.525, P=0.023), SYNTAX score( OR=11.032, 95% CI 1.559~78.071, P=0.016) and glycosylated hemoglobin( OR=18.711, 95% CI 1.418~246.85, P=0.026) were independent risk factors for restenosis after coronary DES implantation.Nomogram scoring model showed that the total score of each influencing factor ranged from 141 to 282, and the corresponding risk rate ranged from 0.1 to 0.9.The higher the total score, the greater the risk of restenosis after coronary DES implantation.The C-index of Nomogram for predicting restenosis after coronary DES implantation was 0.876. Conclusion:Number of lesion vessels, UA, SYNTAX score and glycosylated hemoglobin are independent risk factors for restenosis after coronary DES implantation.Nomogram chart can be used for visual evaluation and provide objective basis for clinical practice.