The Role of Inflammatory Biomarkers in Predicting in-Stent Restenosis

The present study aimed to assess the role of inflammatory markers including erythrocyte sedimentation rate (ESR), highly sensitive C-reactive protein (hs-CRP), neutrophils to lymphocytes ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in predicting ISR. This retrospective case-control study was conducted on 818 consecutive patients suffering acute coronary syndrome and underwent coronary stenting and referred to Rajaie Cardiovascular Medical and Research Center due to being suspicion to ISR. By referring to patients' clinical records as well as accessing their angiographic movie via the Cath lab computer system, patients who had ISR over a two-year period were identified from other patients who did not have re-stenosis. Overall, 19.1% were diagnosed to have ISR within a two-year following-up. However, there was no difference in NLR and PLR across the two ISR (+) and ISR (-) groups. In ISR group, the serum levels of ESR and CRP were significantly higher in smokers versus non-smokers, in diabetics versus non-diabetics, and also in those with chronic kidney disease as compared with those without kidney involvement. The levels of inflammatory indices of ESR and CRP were positively associated with the length of stent and negatively associated with the diameter of stent. Assessing the levels of ESR and CRP can successfully predict ISR in the patients initially undergoing coronary stenting. Such predicting role may be influenced by the interfering role of some cardiovascular risk factors such as smoking, diabetes mellitus, and chronic renal failure.