The Association Between Coronary Instent Restenosis and Eosinophil/ Monocyte Ratio

Abstract

Objectives: Although the incidence of coronary artery restenosis has decreased with the use of novel oral antiplatelet drugs and the use of new generation drug-eluting stents, it is a major problem that we encounter in daily practice due to the prolonged human lifespan and increasing numbers of percutaneous interventions. In this study, we investigated the association between instent restenosis, which is also an inflammatory process, and eosinophil/monocyte ratio (EMR), which is one of the new inflammatory indexes. Materials and Methods: A total of 207 patients admitted with the acute coronary syndrome and underwent coronary angiography between June 2020 and June 2022 were analyzed retrospectively. The patients were divided into three groups: those with stent implantation and culprit lesion with stent restenosis (Group A), those with stent implantation and culprit lesion with the non-stent lesion (Group B), and patients without a stent and no critical lesion (Group C). Demographic characteristics, clinical presentations, comorbidities, hematological and biochemical parameters of the patients were evaluated. Results: EMR was found to be statistically significantly lower in Group A compared in Group B (0.16±0.10 vs 0.40±0.9, p=0.041). There was also a statistically significant difference between the groups in terms of neutrophil (p=0.046) and high-density lipoprotein levels (p=0.010). Additionally, glucose levels at the time of admission were found to be significantly higher in Group A than in Group B (196.53±99.04 vs 159.57±84.31, p=0.048) and Group C (196.53±99.04 vs 140.41±89.66, p=0.001). There was no difference in terms of the levels of white blood cells, lymphocyte, monocyte, eosinophil, platelet, hemoglobin, total cholesterol, low-density lipoprotein, and triglyceride. Conclusion: Since a significant relationship has been shown between the instent restenosis of the culprit lesion and low EMR, EMR can be used as a simple tool to aid in the diagnosis of suspected restenosis in patients with stent implantation presenting with the acute coronary syndrome.