Relationships of a disintegrin and metalloproteinase with thrombospondin motifs 1 in serum and tissue inhibitor of metalloproteinase 3 levels with in-stent restenosis

Objective To investigate relationships of the levels of a disintegrin and metalloproteinase with thrombospondin motifs 1 (ADAMTS-1) and tissue inhibitor of metalloproteinase 3 (TIMP3) in the serum with intrastent restenosis (ISR) in patients with coronary heart disease after percutaneous coronary intervention (PCI).

Methods A total of 455 patients with coronary heart disease who underwent PCI were selected as study objects, and were divided into ISR group (43 cases) and non-ISR group (412 cases) according to the imaging observation results of coronary angiography after one year of follow-up; Gensini score and the number of stenotic branches were used to evaluate the degree of stenosis; Enzyme-Linked Immunosorbent Assay (ELISA) method was used to detect the levels of ADAMTS-1 and TIMP3; Spearman's method was used to analyze the correlations of ADAMTS-1 and TIMP3 levels with Gensini score after angiography; Pearson correlation coefficient method was used to analyze the correlation between ADAMTS-1 and TIMP3; Logistic regression was used to analyze the influencing factors of the occurrence of ISR; receiver operating characteristic (ROC) curve was used to evaluate the predictive value of ADAMTS-1 and TIMP3 for occurrence of ISR.

Results Compared with the non-ISR group, the levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and ADAMTS-1 levels in the ISR group were significantly increased, while the level of TIMP3 was significantly decreased (P < 0.05); in the ISR group, the level of serum ADAMTS-1 was significantly positively correlated with Gensini score (P < 0.05); the level of TIMP3 was significantly negatively correlated with Gensini score (P < 0.05); the level of ADAMTS-1 was significantly negatively correlated with the level of TIMP3 in the ISR group(r=-0.616, P < 0.001); multivariate Logistic regression analysis showed that high level of ADAMTS-1 and low level of TIMP3 were independent risk factors for ISR (P < 0.05); compared with the single prediction of ADAMTS-1 or TIMP3, the area under the ROC curve of the combined prediction of ADAMTS-1 and TIMP3 for ISR was significantly increased (P < 0.05).

Conclusion The levels of ADAMTS-1 and TIMP3 are closely related to the occurrence of ISR in patients with coronary heart disease after PCI. They are independent risk factors for the occurrence of ISR and have important value for predicting the occurrence of ISR.