title: [Predictors of in-stent restenosis in coronary heart disease patients complicating with diabetes mellitus within 2 years after drug-eluting stents implantation].
abstract: OBJECTIVE
  To determine predictors for in-stent restenosis (ISR) within 2 years after drug-eluting stent (DES) implantation in coronary heart disease patients complicating with diabetes mellitus and to establish predictive model.
  
  
  METHODS
  We retrospectively analyzed clinical data of patients underwent DES implantation in our hospital between January 2005 and December 2012. Using random number generated by SPSS 17.0, a total of 3 073 cases were randomly divided into two cohort, model derivation cohort (MDC) and model validation cohort (MVC). MDC (2 048 cases) was divided into in-stent restenosis (ISR) group and control group. Predictors were identified using univariable and multivariable logistic regression analysis in MDC. Integer point values were assigned to each predictor based upon their β coefficient in multivariable logistic regression model to establish scoring model. The summed scores of each case in MVC (1 025 cases) were calculated to test predictive ability of the model.
  
  
  RESULTS
  Of all these 3 073 cases, 217 cases (7.1%) were diagnosed with ISR within 2 year after DES implantation. The incidence of ISR within 2 year after DES implantation was 7.3% (149 cases) in MDC and logistic regression analysis identified six ISR risk factors: multiple target vessels (OR = 3.69, 95%CI: 2.65-8.93, P = 0.000), diffused lesions (OR = 2.92, 95%CI: 2.03-6.46, P = 0.000), GFR < 60 ml×min(-1)·1.73 m(-2) (OR = 4.73, 95%CI: 3.51-10.62, P = 0.000), smoking (OR = 3.37, 95%CI: 2.39-8.46, P = 0.000), age < 60 years old (OR = 1.44, 95%CI:1.26-4.63, P = 0.024), HbAlc ≥ 6.3% (OR = 2.48, 95%CI: 1.84-4.27, P = 0.002). Risk score was well associated with the rate of ISR in MVC. Sensitivity was 76.5% (95%CI: 64.6%-85.9%), specificity was 76.1% (95%CI: 73.2%-78.7%), and areas under the ROC curve was 0.851(95%CI:0.813-0.890, P = 0.000) when score was set at 5.5.
  
  
  CONCLUSIONS
  The incidence of ISR in coronary heart disease patients complicating with diabetes mellitus within 2 years after DES implantation is relatively low. Several factors are associated with ISR in these patients and risk for ISR could be reliably identified by the established scoring model.
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China. Email: cyundai@medmail.com.cn.
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Tian
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jing
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Zhou
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D023903:Coronary Restenosis / Q000209:etiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies