2733-LB: Blood Glucose Status in Relation to Risk of Restenosis after Femoral Artery Angioplasty and Stent Implantation: A Four-Year Follow-up Study

Introduction and Objective: Diabetes (DM) is associated with high risk for restenosis after arterial stenting. Information relating the risk of superficial femoral artery (SFA) angioplasty and stent implantation to impaired glucose regulation is limited. Methods: We retrospectively analyzed data of 257 patients (mean age 62.5±4.7 yrs, 66.2% of men) who undertook SFA angioplasty and stent implantation at between Jan 2017 and Dec 2021. Baseline measures included blood pressure (BP), body mass index (BMI), fasting plasma glucose, lipid profile, HbA1c, C-reactive protein (C-RP), and 2-hour capillary glucose. All patients had 4-year follow-up data of Lower extremity computed tomography angiography (LE-CTA) after first stent implantation. SFA in-stent restenosis was defined as ≧ 50% stenosis in stent or within 5 mm adjacent to stent. The rate of restenosis was compared among patients with normal glucose tolerance (NGT, n=54), impaired glucose regulation (IGR, n=77), and DM (n=126) according to their baseline glucose levels or prior history of DM. Results: Patients with DM had highest levels of BMI, BP, triglycerides (TG), and C-RP, followed by those with IGR and NGT (P<0.05). At year 4, the rate of restenosis, evaluated by LE-CTA, were 9.8%, 14.8%, and 25.6% in patients with NGT, IGR, and DM, respectively (P<0.05). Among DM subgroup, compared with patients with A1c<8%, those with A1c≧8% had increased rate of restenosis (30.6% vs. 25.5%, P<0.05). In the logistic regression model, the odd ratio (OR) of having restenosis was 1.82 (95% CI: 1.17-3.64) for DM and 1.35 (95% CI: 1.02-2.27) for IGR, after adjusting for age, gender, smoking, use of statin, use of anticoagulant drug, BMI, BP, LDL-C, TG, HbA1c and C-RP. Conclusion: IGR is associated with increased risk of restenosis after SFA angioplasty and stent implantation during a 4-year follow-up period. The data indicates that early intervention of hyperglycemia should be addressed in the management of Lower extremity arterial disease. Disclosure G. Guo: None. Y. Ding: None. M. Wang: None. J. Yao: None. L. Li: None. L. Zhang: None.