High coronary calcium score and post-procedural CK-MB are noninvasive predictors of coronary stent restenosis

Figures & data

Table 1 Baseline clinical characteristics in groups with and without TLR

	Group 1: non-TLR (n=910)	Group 2: TLR patients (n=162)	P-value
Male sex	592 (56.2)	95 (58.6)	0.13
Age (years)	63.4±10.1	62.1±9.0	0.07
BMI (kg/m^2)	25.41±4.00	24.5±3.2	0.06
DM	202 (22.1)	34 (39.0)	0.11
HBP	402 (44.1)	86 (72.8)	0.12
Smoking	167 (18.3)	43 (26.5)	0.40
FBG (mg/dL)	123.7±43.9	121.6±40.2	0.40
HbA1c (%)	6.4±1.1	6.4±1.2	0.53
Creatinine (mg/dL)	1.07±0.6	1.1±0.3	0.20
CRP (IU)	8.6±11.8	9.3±17.4	0.57
TC (mg/dL)	170.3±43.1	165.5±44.2	0.91
TG (mg/dL)	136.48±80.07	144.3±97.0	0.12
HDL (mg/dL)	41.9±11.6	42.3±10.3	0.41
LDL (mg/dL)	101.9±39.2	95.3±32.5	0.60
Pro-BNP (pg/mL)	424.9±1.6	423.7±1.2	0.83
Calcium score	345.8±51.05	1,102.4±743.7	0.04*
Post-procedural CK-MB elevationa	157 (17.2)	135 (83.3)	0.02*
Stent type (lesion)
PES	322 (35.3)	82 (37.3)	0.04*
SES	816 (69.6)	114 (51.8)	0.09
EES	68 (5.2)	9 (4.1)	0.23
ZES	91 (7.1)	15 (6.8)	0.45
Stent diameter (mm)	3.20±0.6	3.18±1.9	0.84
Stent length (mm)	32.4±11.4	34.8±17.2	0.07
True bifurcation	270 (29.6)	42 (25.9)	0.24
AHA/ACC lesion B2/C	188 (20.6)	32 (19.8)	0.81
Side branch occlusion (≥2.5 mm)	19 (2.1)	4 (2.2)	0.20

Notes:

* P<0.05.

a Patient number (>2 times elevation of the upper normal limit). Data presented as mean ± standard deviation or n (%).

Abbreviations: BMI, body mass index; CK-MB, creatine kinase MB form; CRP, C-reactive protein; DM, diabetes mellitus; EES, everolimus eluting stent; FBG, fasting blood glucose; HBP, hypertension; HDL, high-density lipoprotein; LDL, low-density lipoprotein; PES, paclitaxel eluting stent; pro-BNP, pro B-type natriuretic peptide; SES, sirolimus eluting stent; stent type, coronary stent type; TC, total cholesterol; TG, triglyceride; TLR, target lesion revascularization; ZES, zotarolimus eluting stent; AHA, American College of Cardiology; ACC, American Heart Association.

Table 2 Logistic regression analysis of the influencing factors for prediction of TLR in lesions

Factor	Univariate analysis		Multivariate analysis
	OR (95% CI)	P-valve	OR (95% CI)	P-value
Sex	0.89 (0.67–1.19)	0.37	–	–
Age	1.18 (0.99–1.32)	0.37	1.13 (0.94–1.19)	0.49
BMI	0.95 (0.90–0.99)	0.02*	0.92 (0.35–1.24)	0.48
DM	1.27 (0.87–1.69)	0.13	0.84 (0.18–2.22)	0.39
HBP	1.42 (1.03–2.06)	0.02*	2.11 (0.78–11.9)	0.16
Smoking	0.83 (0.59–1.19)	0.24	–	–
FBG	0.99 (0.99–1.00)	0.47
HbA1c	1.10 (0.89–1.12)	0.91	–	–
Creatinine	1.20 (0.90–1.30)	0.32	–	–
hs-CRP	1.45 (0.49–1.95)	0.88	–	–
TC	1.10 (0.99–1.20)	0.75	–	–
TG	1.23 (0.79–1.24)	0.21	–	–
HDL	0.99 (0.98–1.01)	0.60	–	–
LDL	0.99 (0.99–1.02)	0.50	–	–
Stent type		0.04*	–	0.73
PES	0.54 (0.40–0.70)	<0.01*	0.65 (0.19–2.17)	0.41
SES	0.23 (0.05–0.61)	0.06	1.00 (0.98–1.13)	0.91
EES	0.71 (0.38–1.21)	0.24	2.04 (0.42–10.09)	0.36
ZES	0.97 (0.12–1.28)	0.13	3.06 (0.14–67.11)	0.49
Stent diameter	1.017 (0.86–1.19)	0.84	–	–
Stent length	1.028 (1.01–1.03)	0.11	1.05 (1.02–1.09)	0.22
Calcium score	1.41 (1.20–1.51)	0.01*	1.30 (1.19–1.48)	0.01*
CK-MB elevationa (post-procedure)	1.60 (1.33–1.70)	0.02*	1.45 (1.28–1.51)	0.02*

Notes:

* P<0.05.

a More than two times elevation of the upper normal limit.

Abbreviations: BMI, body mass index; CK-MB, creatine kinase MB; CI, confidence interval; DM, diabetes mellitus; EES, everolimus eluting stent; FBG, fasting blood glucose; HBP, hypertension; HDL, high-density lipoprotein; hs-CRP, high sensitive C-reactive protein; LDL, low-density lipoprotein; OR, odds ratio; PES, paclitaxel eluting stent; SES, sirolimus eluting stent; stent type, coronary stent type; TC, total cholesterol; TG, triglyceride; TLR, target lesion revascularization; ZES, zotarolimus eluting stent.

Table 3 Incidence of target lesion revascularization according to coronary calcium score and post-procedural CK-MB elevation

CK-MB elevationa (%)	Group I, CCS <300		Group II, 300≤ CCS ≤800		Group III, CCS >800
	TLR (−), (n=396)	TLR (+), (n=7)	TLR (−), (n=270)	TLR (+), (n=45)	TLR (−), (n=244)	TLR (+), (n=110)
(−)	356 (85.8)	5 (1.2)	224 (68.9)	10 (3.0)	173 (51.3)	12 (3.5)
(+)	40 (9.6)	2 (0.4)	46 (14.1)	35 (10.7)	71 (21.0)	98 (29.0)*

Notes:

* P<0.05 compared to Groups I and II.

a Patient number (>2 times elevation of the upper normal limit). Data presented as n (%).

Abbreviations: CCS, coronary calcium score; CK-MB, creatine kinase MB form; TLR, target lesion revascularization.

Figure 1 On the receiver operating curve, the calcium score was a significant predictor for TLR. A calcium score of 800 has a sensitivity of 60% and specificity of 85%.

Abbreviations: AUC, area under curve; TLR, target lesion revascularization.