The value of serum visfatin in predicting in-stent restenosis of drug-eluting stents.

Objective: This study aims to determine the association between serum visfatin level and in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) using drug-eluting stents (DES).

Methods: A total of 460 patients with stable coronary heart disease who underwent DES placement were included. According to the results of coronary angiography 1year after PCI, 62 patients diagnosed as ISR were enrolled into the ISR group and 398 patients without ISR were recruited into the control group. Baseline clinical data were collected, and serum visfatin level was measured using ELISA method.

Results: The serum visfatin levels before PCI were not different between ISR and control groups (P=0.41). However, visfatin level after PCI in the ISR group was significantly higher than in the control group [(30.2±8.6) ng/ml vs. (22.6±7.9) ng/ml, P<0.01]. In multivariate logistic regression, the independent predictors for ISR included post-procedural visfatin level (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.19-3.65), type 2 diabetes (OR: 2.30, 95% CI: 1.10-4.79), reference vessel diameter (OR: 0.79, 95% CI: 0.63-0.98), stent length (OR: 1.52, 95% CI: 1.05-2.21) and stent diameter (OR: 0.67, 95% CI: 0.51-0.88). ROC curve analysis indicated that the area under the curve for post-procedural visfatin in predicting ISR was 0.82 (95% CI: 0.77-0.86), with the optimal cut-off value of 25.9ng/ml showing a sensitivity of 84.0% and a specificity of 69.3%.

Conclusion: Increased serum visfatin level after DES placement is independently associated with ISR. Serum visfatin may be useful in the prediction of ISR.