Predictive value of preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and haemoglobin levels for in-stent restenosis after bioresorbable scaffold implantation in patients with lower-extremity arterial occlusive disease

OBJECTIVE: To investigate the predictive value of preoperative neutrophil-to-lymphocyte ratios (NLRs), platelet-to-lymphocyte ratios (PLRs) and haemoglobin (HGB) levels for in-stent restenosis (ISR) after bioresorbable scaffold (BRS) implantation in patients with lower-extremity arteriosclerosis obliterans (LEASO). METHODS: A total of 53 patients with superficial femoral artery stenosis or occlusion admitted to multiple hospitals in one city between January 2023 and June 2024 were enrolled in this retrospective study. After screening the participants based on the inclusion and exclusion criteria, with a follow-up period extending to 1 year postoperatively, they were divided into an ISR group (n = 37) and a non-ISR group (n = 13) according to the occurrence of ISR. Comparative analyses were performed using t-tests and chi-squared (χ2) tests to evaluate patients' medical histories, stent implantation characteristics, complete blood count parameters and blood biochemical indicators, followed by logistic regression analysis to identify independent influencing factors. RESULTS: Patients in the ISR group had significantly longer recorded stent lengths and exhibited higher NLRs and PLRs - but lower HGB levels - than patients in the non-ISR group. Logistic regression analysis identified NLRs and PLRs as independent risk factors for postoperative ISR in patients with LEASO. Receiver operating characteristic curve analysis revealed an area under the curve (AUC) of 0.740 for HGB, 0.843 for NLR and 0.794 for PLR. The combined predictive model achieved an AUC of 0.915. CONCLUSION: Elevated preoperative NLRs and PLRs, alongside decreased HGB levels, are associated with an increased risk of ISR following BRS implantation in patients with LEASO and show promising predictive value.