Key result
Elevated pre-PCI IL-6 and Gensini score predict in-stent restenosis after DES, unlike hsCRP.
Why the study?
In-stent restenosis remains a major limitation of PCI, and inflammatory biomarkers such as IL-6 and hsCRP may contribute to its pathogenesis. This study evaluated the predictive value of IL-6, hsCRP, and the Gensini score for in-stent restenosis in CAD patients undergoing drug-eluting stent implantation.
Do pre-procedural levels of interleukin-6, high-sensitivity C-reactive protein, and the Gensini score predict in-stent restenosis at 6 to 12 months in patients with coronary artery disease undergoing drug-eluting stent implantation?
Cohort (n=262)
No
Do pre-procedural levels of interleukin-6, high-sensitivity C-reactive protein, and the Gensini score predict in-stent restenosis at 6 to 12 months in patients with coronary artery disease undergoing drug-eluting stent implantation?
Pre-procedural interleukin-6 levels and angiographic Gensini scores have moderate predictive value for 6-to-12-month in-stent restenosis following drug-eluting stent implantation, whereas hsCRP alone shows limited predictive utility.
Background and Aims: In-stent restenosis (ISR) remains a major limitation of percutaneous coronary intervention (PCI). Inflammatory biomarkers such as interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) may contribute to ISR pathogenesis. This study aimed to evaluate the predictive value of IL-6, hsCRP, and the Gensini score (GS) for ISR in patients with coronary artery disease (CAD) undergoing drug-eluting stent implantation. Methods and Results : A total of 262 CAD patients treated with PCI were enrolled. Patients were classified into ISR (n=107) and non-ISR (n=155) groups. ISR was assessed by protocol-driven coronary angiography performed between 6 and 12 months in all patients. Clinical, angiographic, and biochemical parameters were assessed. IL-6 and hsCRP levels were measured pre-procedurally, and CAD severity was evaluated by the Gensini score. Receiver operating characteristic (ROC) curve analysis was performed to determine predictive values. Serum IL-6, hsCRP levels, and GS values were significantly higher in the ISR group when compared with No ISR group (p=0.012, p=0.017, and p=0.032, respectively). ROC analysis showed moderate predictive value for IL-6 (AUC=0.717, p=0.012) and GS (AUC=0.674, p=0.040), whereas hsCRP did not reach statistical significance (AUC=0.602, p=0.171). Conclusions: Elevated IL-6 and increased GS were significantly associated with ISR, highlighting the importance of both systemic inflammation and angiographic CAD severity in restenosis risk. ClinicalTrials.gov Number: NCT03075566 (09/03/2017).
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Bouzidi et al. (2026) conducted a cohort in Coronary artery disease undergoing percutaneous coronary intervention with drug-eluting stents (n=262). Pre-procedural serum Interleukin-6 (IL-6), hsCRP, and Gensini score vs. No in-stent restenosis (non-ISR group) was evaluated on In-stent restenosis (ISR) predicted by pre-procedural IL-6 (pg/mL) (AUC 0.717, 95% CI 0.560-0.874, p=0.012). Elevated pre-procedural IL-6 (AUC 0.717, p=0.012) and Gensini score (AUC 0.674, p=0.040), but not hsCRP (p=0.171), significantly predicted in-stent restenosis after drug-eluting stent PCI.
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