The relationship between serum TMAO and S100A4 levels and in-stent restenosis after percutaneous coronary intervention in patients with unstable angina
DU Honglei
CHENG Hao
Tao Lei
Abstract：Objective To discuss the relationship between serum trimethylamine N-oxide(TMAO)and S100 calcium binding protein A4(S100A4)and in-stent restenosis after percutaneous coronary intervention(PCI)in patients with unstable angina(UA).Methods A total of 195 UA patients who visited Yantai Yeda Hospital from January 2022 to January 2024 were selected and included in the UA group;additionally,120 healthy volunteers of similar age who underwent physical examinations at the same hospital during the same period were selected and included in the healthy control group.The differences in serum TMAO and S100A4 levels between UA patients after 1 week of treatment and healthy control subjects at the time of their physical examination were measured using enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to assess the correlation between TMAO and S100A4 levels in UA patients.All UA patients underwent a 1-year follow-up,and those experiencing physical discomfort underwent coronary angiography.Based on whether patients developed ISR,the UA group was divided into ISR and non-ISR groups.The clinical data as well as changes in TMAO and S100A4 levels between ISR and non-ISR groups were compared.Logistic regression analysis was used to identify risk factors for ISR in UA patients,and receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive efficacy of serum TMAO and S100A4 levels for ISR in UA patients.Results After one week of treatment,UA patients had higher levels of low-density lipoprotein cholesterol,serum TMAO,and S100A4 compared to healthy individuals,while their high-density lipoprotein cholesterol levels were lower than those of the healthy group(P<0.05).Serum TMAO levels in UA patients were positively correlated with S100A4 levels(r=0.560,P<0.001).Coronary angiography results indicated that in the UA group,43 patients developed ISR(ISR group),while 152 patients did not(non-ISR group).HDL cholesterol levels in ISR patients were lower than those in the non-ISR group,whereas stent length,LDL cholesterol,TMAO,and S100A4 levels were higher than those in the non-ISR group(P<0.05).High levels of serum TMAO,S100A4,and longer stent length are risk factors for ISR in UA patients(P<0.05).The area under the curve(AUC)values of serum TMAO,S100A4,and their joint in predicting ISR in UA patients were 0.801,0.781,and 0.879,respectively,the joint prediction performance of two indicators was better than that of a single indicator,and its prediction performance was high(ZTMAO-joint prediction=2.033,ZS100A4 joint prediction=2.560,P=0.042,P=0.010).Conclusion After PCI treatment,UA patients show increased serum TMAO and S100A4 levels.The elevation of these two indicators can lead to a higher risk of ISR in patients.Clinically,the probability of ISR in UA patients after PCI can be effectively assessed by changes in the levels of these two markers.
Keywords：unstable anginapercutaneous coronary interventiontrimethylamine N-oxideS100 calcium binding protein A4in-stent restenosis
Publication Date：2025-11-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：5( 1353-1357 )