Blood Level of CD45+ Platelets and Development of Restenosis after Drug-Eluting Stent Implantation in Patients with Stable Coronary Artery Disease and Type 2 Diabetes Mellitus

The objective of the study: is assessment of novel biomarkers for restenosis occurrence after drug-eluting stent (DES) implantation in patients with stable coronary artery disease (CAD) and type 2 diabetes mellitus.
Materials and methods: The study comprised 126 patients with stable angina pectoris, who underwent elective coronary artery stenting with DES and follow-up angiography within 6-12 months thereafter. According to the presence of diabetes mellitus, the patients were assigned to a group with type 2 diabetes mellitus (n=55) and to a group without diabetes (n=71). Blood levels of CD45+ platelets, clinical, laboratory and angiographic variables, which might affected the development of restenosis, were compared in both groups. The logistic regression model for the prognosis of restenosis occurrence was built.
Results: We identified two factors with strong ability to predict development of restenosis after DES implantation in patients with diabetes. The resulting logit regression equation included circulating CD45+ platelets (OR=4.50, p=0.007), neutrophil to lymphocyte ratio (OR=3.09, p=0.004) and diabetes mellitus (OR=2.50, p=0,013). Receiver-Operating Characteristic curve analysis showed the high prognostic value of the model (AUC=0,83±0,05, p<0,001). Angiographic characteristics such as stenting of long stenosis, number of simultaneously implanted stents or small diameter of stented arteries didn’t affect the predictive ability of the model in patients with type 2 diabetes mellitus.
Conclusion: Our data show that there is a close relationship between two inflammatory biomarkers, the level of circulating CD45+ platelets and neutrophil to lymphocyte ratio, and occurrence of restenosis after DES implantation in patients with CAD and concomitant type 2 diabetes mellitus. In the presence of diabetes mellitus inflammatory biomarkers have higher ability to predict the development of restenosis and non-inflammatory biomarkers lose their significance, which is in contrast with the general population.
Sources of funding: This work was supported by the grant of the Russian Science Foundation (project #16-15-10098).