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Abstract Background Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of clinical, laboratory, and even genetic factors make people susceptible to such a phenomenon and in fact, this is multi-factorial. We aimed to first determine the underlying clinical and laboratory risk factors for the occurrence of stent re-stenosis after PCI based on a systematic review study, and after that, through a bioinformatics study, to evaluate the related genes and microRNAs with the occurrence of stent re-stenosis. Main text In the first step, the manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the considered keywords to introduce clinical and laboratory determinants of stent re-stenosis. In the bioinformatic phase, and following a review of the literature to identify genes and microRNAs involved in restenosis, the interaction of each gene with other genes associated with stent re-stenosis was determined by GeneMANIA network analysis and Cytoscape software. Overall, 67 articles (including 40,789 patients) on clinical and biochemical predictors for stent restenosis and 25 articles on genetic determinants of this event were eligible for the final analysis. The predictors for this event were categorized into four subgroups patient-based parameters including traditional cardiovascular risk profiles, stent-based parameters including type and diametric characteristics of the stents used, coronary lesion-based parameters including several two target lesions and coronary involvement severity and laboratory-based parameters particularly related to activation of inflammatory processes. In the bioinformatic phase, we uncovered 42 genes that have been described to be involved in such a phenomenon considering a special position for genes encoding inflammatory cytokines. Also, 12 microRNAs have been pointed to be involved in targeting genes involved in stent re-stenosis. Conclusions The incidence of stent re-stenosis will be the result of a complex interaction of clinical risk factors, laboratory factors mostly related to the activation of inflammatory processes, and a complex network of gene-to-gene interactions.

Abstract Background The value of counting inflammatory cells and especially their counting ratio in predicting adverse clinical outcomes in patients with acute coronary syndrome (ACS) undergoing revascularization has been shown, but the results of studies have been very diverse and paradoxical. The aim of the current study was to systematically review the studies that investigated the role of increased neutrophil-to-lymphocyte ratio (NLR) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods Data abstraction was independently performed by both un-blinded reviewers on deeply assessing Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials and using the relevant keywords. The risk of bias for each study was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the QUADAS-2 tool. Statistical analysis was performed using the Stata software. Overall, 14 articles published between 2010 and 2021 were eligible for the final analysis. Results A total of 20,846 ACS patients undergoing PCI were included. Higher values of NLR were associated with higher numbers of involved coronaries (RR: 1.175, 95%CI 1.021–1.353, P = 0.024). Increasing the value of NLR was associated with a 3.4 times increase in long-term death (RR: 3.424, 95%CI 2.325–5.025, P = 0.001). Similarly, higher values of NLR were significantly associated with a higher likelihood of long-term MACE (RR: 2.604, 95%CI 1.736–3.906, P = 0.001). Conclusions NLR has a high value in predicting both the severity of coronary artery involvement and long-term adverse clinical outcomes following the PCI procedure.

Background: The successful management of ventricular septal defect (VSD) has been possible through the development of advanced techniques. In this regard, percutaneous VSD closure by employing different types of occluders as an alternative for surgery can help to achieve the most desirable postprocedural consequences. However, the studies reported contradictory results on the use of different brands of VSD occluders. Herein, we performed a systematic review and meta-analysis of published studies to assess pooled long-term success rate and potential complications of using the Nit-Occlud Lê VSD coil for VSD closure. Materials and Methods: Two reviewers began to deeply search the various databases for all eligible studies in accordance with the considered keywords. The inclusion criterion for retrieving the studies was to describe the mid-term or long-term consequences of VSD closing by the Nit-Occlud Lê VSD coil device. In the final, eight articles were eligible for the analysis. The follow-up time of the studies ranged from 6 months to 5 years. Results: The success rate of the procedure ranged from 87.0% to 100% considering the weight of each study, the pooled success rate of VSDs closure by Nit-Occlud Lê VSD coil device was 93.1% (95% confidence interval [CI]: 89.9% to 95.5%). The pooled prevalence of postprocedural residual shunt was estimated to be 9.6% (95%CI: 6.8% to 13.4%). The corrected pooled prevalence of trivial mild aortic regurgitation (AR) was 2.9% (95%CI: 1.5% to 5.4%); however, moderate-to-severe AR and complete heart block or right bundle branch block were shown to be rare. Conclusion: VSD closure using a Nit-Occlud Lê VSD coil device can lead to a high success rate with low rates of residual shunt, cardiac conductive or vascular disturbances.