Plasma miR-21-5p and miRNA-93-5p Levels as Early Assessment Tools for In-Stent Restenosis Following Endovascular Stenting Treatment in Patients with Lower Extremity Atherosclerotic Disease.

In-stent restenosis (ISR) still remains a leading cause of failure of interventional therapy in patients with lower extremity atherosclerotic disease (LEAD). Sensitive and reliable biomarkers to predict ISR should be identified. This study aims to investigate predictive values of two microRNAs, miR-21-5p and miR-93-5p for ISR following endovascular stenting treatment. A total of 128 LEAD patients receiving endovascular stenting treatment were included into the study and their restenotic status followed up by computed tomography angiography after 6 months to examine the incidence of ISR. The results of two-way ANOVAs showed a significant effect of ISR presence, time, and ISR × time interaction on the plasma level of miR-21-5p and miR-93-5p among LEAD patients, which reduced at the postoperative 14^th day. The following multiple comparisons test showed higher plasma level of miR-21-5p and miR-93-5p at the postoperative 14^th day in the ISR than the non-ISR (P < 0.0001). The plasma levels of miR-21-5p and miR-93-5p at 14 days after surgery used alone or combination as a test to predict ISR occurrence 6 months after surgery produced an AUC of 0.845, 0.839, and 0.906, respectively. Multiple logistic regression analysis revealed the plasma levels of miR-21-5p and miR-93-5p at 14 days after surgery were risk factors for LEAD patients developing ISR at 6 months after surgery (P < 0.001). Our results suggest that plasma miR-21-5p and miR-93-5p levels at 14 days after surgery may serve as potential biomarkers for developing ISR following endovascular stenting treatment among LEAD patients.