Fasting Blood Glucose but not TMAO is Associated with In-Stent Restenosis in Patients with Acute Coronary Syndrome

Background: The purpose of our study was to assess whether the occurrence of ISR might be associated with plasma TMAO levels in patients with ACS after DES implantation. Methods: This was a single center retrospective case-control study, in which 64 symptomatic patients with repeated coronary angiography after PCI and 15 patients with ISR were included in the ISR group, and 49 patients without ISR were included in the non-ISR group. High-performance liquid chromatography with tandem mass spectrometry was used to measure plasma TMAO levels. Results: No significant differences were observed in plasma TMAO between the ISR and non-ISR groups. Plasma TMAO levels showed no significant correlation with ISR, but were significantly positively correlated with diabetes mellitus, serum HbA1c levels and serum creatinine levels; moreover, they were significantly negatively correlated with female sex. ISR was significantly positively correlated with diabetes mellitus, fasting blood glucose levels, the neutrophil to lymphocyte ratio and syntax score; in addition, it was significantly negatively correlated with platelets. Logistic regression analysis indicated that fasting blood glucose was the only independent predictor of ISR. Conclusion: Plasma TMAO may not be associated with ISR and plaque burden in patients with ACS after DES implantation, whereas FBG may predict the development of ISR in these patients.