Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents

Background: In the era of drug-eluting stents (DESs), few studies have explored the association between arterial stiffness and the risk of in-stent restenosis (ISR). Methods: Pulse pressure and pulse pressure in...

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Main Authors: Yiquan Huang, Shaozhao Zhang, Xiaomin Ye, Zhuoshan Huang, Zhenyu Xiong, Xiangbin Zhong, Yifen Lin, Menghui Liu, Xiaodong Zhuang, Xinxue Liao
Format: Article
Language:English
Published: IMR Press 2025-06-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/26/6/10.31083/RCM23847
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author Yiquan Huang
Shaozhao Zhang
Xiaomin Ye
Zhuoshan Huang
Zhenyu Xiong
Xiangbin Zhong
Yifen Lin
Menghui Liu
Xiaodong Zhuang
Xinxue Liao
author_facet Yiquan Huang
Shaozhao Zhang
Xiaomin Ye
Zhuoshan Huang
Zhenyu Xiong
Xiangbin Zhong
Yifen Lin
Menghui Liu
Xiaodong Zhuang
Xinxue Liao
author_sort Yiquan Huang
collection DOAJ
description Background: In the era of drug-eluting stents (DESs), few studies have explored the association between arterial stiffness and the risk of in-stent restenosis (ISR). Methods: Pulse pressure and pulse pressure index (PPI), which are noninvasive measures of arterial stiffness, were measured before percutaneous coronary interventions (PCI). PPI is the ratio of pulse pressure to systolic blood pressure. ISR was defined based on the angiographic evidence of ≥50% stenosis within the previously stented segment. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for ISR. Results: A total of 644 patients were collected, including 72 patients in the ISR group. Pulse pressure and PPI were significantly higher in the ISR group (ISR vs no ISR: pulse pressure, 58.5 ± 16.3 vs 53.1 ± 13.7 mmHg [p = 0.002]; PPI, 0.43 ± 0.07 vs 0.40 ± 0.07 [p = 0.001]). Multivariable-adjusted ORs for ISR, for tertile3 vs. tertile1, were 2.73 (95% CI, 1.33–5.62; p = 0.006) and 2.12 (95% CI, 1.04–4.31; p = 0.038) for pulse pressure and PPI, respectively. The ORs for ISR with a 1-standard deviation (SD) increase in pulse pressure and PPI were 1.41 (95% CI, 1.09–1.83; p = 0.010) and 1.52 (95% CI, 1.15–2.01; p = 0.003), respectively. Conclusions: Arterial stiffness denoted by high pulse pressure and PPI is a predictive factor for ISR. A pre-PCI wide pulse pressure could potentially serve as a marker of risk, as well as a potential target for future therapies. Clinical trial registration: ChiCTR2000039901, https://www.chictr.org.cn/showproj.html?proj=51063.
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issn 1530-6550
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publishDate 2025-06-01
publisher IMR Press
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series Reviews in Cardiovascular Medicine
spelling doaj-art-789bd052d9944e3b95b1992a9c37cdee2025-08-20T02:42:53ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-06-012662384710.31083/RCM23847S1530-6550(24)01506-0Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting StentsYiquan Huang0Shaozhao Zhang1Xiaomin Ye2Zhuoshan Huang3Zhenyu Xiong4Xiangbin Zhong5Yifen Lin6Menghui Liu7Xiaodong Zhuang8Xinxue Liao9Department of Cardiology, Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361003, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaNHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University), 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaCardiology Department, First Affiliated Hospital of Sun Yat-Sen University, 510080 Guangzhou, Guangdong, ChinaBackground: In the era of drug-eluting stents (DESs), few studies have explored the association between arterial stiffness and the risk of in-stent restenosis (ISR). Methods: Pulse pressure and pulse pressure index (PPI), which are noninvasive measures of arterial stiffness, were measured before percutaneous coronary interventions (PCI). PPI is the ratio of pulse pressure to systolic blood pressure. ISR was defined based on the angiographic evidence of ≥50% stenosis within the previously stented segment. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for ISR. Results: A total of 644 patients were collected, including 72 patients in the ISR group. Pulse pressure and PPI were significantly higher in the ISR group (ISR vs no ISR: pulse pressure, 58.5 ± 16.3 vs 53.1 ± 13.7 mmHg [p = 0.002]; PPI, 0.43 ± 0.07 vs 0.40 ± 0.07 [p = 0.001]). Multivariable-adjusted ORs for ISR, for tertile3 vs. tertile1, were 2.73 (95% CI, 1.33–5.62; p = 0.006) and 2.12 (95% CI, 1.04–4.31; p = 0.038) for pulse pressure and PPI, respectively. The ORs for ISR with a 1-standard deviation (SD) increase in pulse pressure and PPI were 1.41 (95% CI, 1.09–1.83; p = 0.010) and 1.52 (95% CI, 1.15–2.01; p = 0.003), respectively. Conclusions: Arterial stiffness denoted by high pulse pressure and PPI is a predictive factor for ISR. A pre-PCI wide pulse pressure could potentially serve as a marker of risk, as well as a potential target for future therapies. Clinical trial registration: ChiCTR2000039901, https://www.chictr.org.cn/showproj.html?proj=51063.https://www.imrpress.com/journal/RCM/26/6/10.31083/RCM23847arterial stiffnessdrug-eluting stentsin-stent restenosispulse pressurepulse pressure index
spellingShingle Yiquan Huang
Shaozhao Zhang
Xiaomin Ye
Zhuoshan Huang
Zhenyu Xiong
Xiangbin Zhong
Yifen Lin
Menghui Liu
Xiaodong Zhuang
Xinxue Liao
Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents
Reviews in Cardiovascular Medicine
arterial stiffness
drug-eluting stents
in-stent restenosis
pulse pressure
pulse pressure index
title Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents
title_full Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents
title_fullStr Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents
title_full_unstemmed Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents
title_short Impact of Arterial Stiffness on In-Stent Restenosis in the Era of Drug-Eluting Stents
title_sort impact of arterial stiffness on in stent restenosis in the era of drug eluting stents
topic arterial stiffness
drug-eluting stents
in-stent restenosis
pulse pressure
pulse pressure index
url https://www.imrpress.com/journal/RCM/26/6/10.31083/RCM23847
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