Arginine vasopressin deficiency following SARS-CoV-2 infection: a rare pituitary complication.

Coronary heart disease is a leading cause of global morbidity and mortality and remains the primary cause of death in China. According to the from the National Center for Cardiovascular Disease, among the 330 million individuals affected by cardiovascular diseases, 11.39 million have been diagnosed with CHD. Percutaneous coronary intervention (PCI) has become the primary strategy for coronary artery revascularization in patients with coronary artery disease. In 2018, the average incidence of PCI in China was 651 cases per million population, with an average of 1.46 stents placed per patient, and the mortality rate of coronary intervention was reported at 0.26%. The introduction and advancement of drug-eluting stents (DES) have significantly improved the efficacy and safety of PCI by markedly reducing the incidence of in-stent restenosis (ISR). However, despite the widespread use of DES, ISR continues to occur in approximately 5%–15% of patients, presenting a critical challenge in the management of CHD. The development of ISR is a progressive process driven by multiple pathophysiological mechanisms, with atherosclerosis playing a central role. As a result, identifying independent predictive factors for ISR and developing strategies to reduce its incidence have become essential research priorities to enhance clinical outcomes. The development of ISR is a progressive process driven by multiple pathophysiological mechanisms, including systemic and procedural factors. Established systemic risk factors include diabetes mellitus, renal insufficiency, hypertension, and a history of coronary artery bypass grafting. Meanwhile, procedural determinants such as stent type, stent length, poor stent-vessel wall apposition, and perioperative complications like contrast-induced nephropathy have been consistently linked to higher ISR incidence. Beyond these systemic and procedural factors, circulating biomarkers, particularly lipid-related parameters, also serve as important risk factors for ISR. Low-density lipoprotein cholesterol (LDL-C) has long been recognized as a key risk factor for atherosclerotic cardiovascular disease and ISR. Nevertheless, numerous studies have shown that patients may still be at high risk for cardiovascular disease, even when LDL-C levels are within recommended ranges. To compensate for the limitations of LDL-C, multiple novel lipid parameters have been explored in recent years. The monocyte to high-density lipoprotein ratio has been found to be correlated with ST-segment elevation myocardial infarction patients treated with bare-metal stent implantation, which can effectively reflect vascular inflammation and endothelial repair status after coronary intervention. In addition, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is independently associated with the risk of ISR after DES implantation in patients with CHD and exhibits a superior predictive capacity for ISR compared to other lipid parameters. Although these lipid parameters have shown promising predictive performance, these biomarkers cannot fully explain residual restenosis risk.