Exploring the Novel Potential of Serum SIRT1 and TIMP3 as Biomarkers for In-Stent Restenosis Following Percutaneous Transluminal Angioplasty and Stenting in Arteriosclerosis Obliterans Patients

Abstract

This study aimed to investigate the potential of serum Sirtuin 1 (SIRT1) and tissue inhibitor of metalloproteinase 3 (TIMP3) levels as biomarkers for in-stent restenosis (ISR) in arteriosclerosis obliterans (ASO) patients following percutaneous transluminal angioplasty (PTA) and stenting. A total of 256 ASO patients who underwent successful PTA with stent implantation were included. Serum levels of SIRT1 and TIMP3 were assessed at baseline and 4 weeks post-procedure. After 6 months, 65 patients were identified with ISR. Significant differences were noted in serum SIRT1 and TIMP3 levels between ISR and non-ISR groups at 4 weeks. TIMP3 had a higher AUC (0.782, 95% CI: 0.726-0.831) than SIRT1 (0.737, 95% CI: 0.678-0.789) for predicting ISR at 6 months. Correlation analysis showed a positive association between SIRT1 and TIMP3 levels in ISR patients at 4 weeks, but not in non-ISR patients. Multivariate analysis revealed diabetes (OR = 1.436, 95% CI: 1.205-1.925) and carotid stenosis (OR = 4.551, 95% CI: 1.364-15.185) significantly increased ISR risk, while lower SIRT1 (OR = 0.985, 95% CI: 0.978-0.992) and TIMP3 (OR = 0.574, 95% CI: 0.464-0.710) levels were significantly associated with ISR. Serum SIRT1 and TIMP3 levels at 4 weeks post-procedure are significant predictors of ISR in ASO patients following PTA and stenting. Lower SIRT1 and TIMP3 levels correlate with higher ISR risk. These findings suggest that monitoring serum SIRT1 and TIMP3 levels could be a valuable tool in predicting ISR, which could inform clinical decisions and patient management.