摘要Background:It is known that there is a definite association between platelet distribution width (PDW) and poor prognosis in patients with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM).However,there are no data available regarding the prognostic significance of PDW for in-stent restenosis (ISR) in patients with CAD and T2DM.We aimed to determine the value of PDW on admission that predicted ISR in patients with CAD and T2DM.Methods:Between January 2012 and December 2013,a total of 5232 consecutive patients diagnosed with CAD and T2DM undergoing percutaneous coronary intervention were admitted.Three years of retrospective follow-up was undertaken.A total of 438 patients with second angiography operations were included.ISR was defined as ≥50％ luminal stenosis of the stent or peri-stent segments.Continuous data were presented as the mean ± standard deviation or median (P25,P75) and were compared by one-way analysis of variance or Kruskal-Wallis H-test.Categorical variables were presented as percentages and were compared by Chi-square test or Fisher's exact test.The association between PDW and ISR was calculated by logistic regression analysis.A two-sided value of P ＜ 0.05 was considered statistically significant.Statistical analyses were performed by SPSS version 22.0 for windows.Results:Fifty-nine patients with ISR,accounting for 13.5％ of the total,were included.ISR was significantly more frequent in patients with higher PDW quartiles compared with lower quartiles.We observed that PDW had a strong relationship with mean platelet volume (r =0.647,95％ confidence interval [CI]:0.535-0.750,P ＜ 0.0001).The receiver-operating characteristic curves showed that the PDW cutoffvalue for predicting ISR rate was 13.65 fl with sensitivity of 59.3％ and specificity of 72.4％ (area under curve [AUC] =0.701,95％ CI:0.625 0.777,P ＜ 0.001).Multivariate analysis showed that the risk of ISR increased approximately 30％ when PDW increased one unit (odds ratio [OR]:1.289,95％ CI:1.110-1.498,P=0.001).Patients with higher PDW,defined as more than 13.65 fl,had a 4-fold higher risk of ISR compared with lower PDW (OR:4.241,95％ CI:1.879-9.572,P=0.001).Furthermore,when patients were divided by PDW quartiles values,PDW was able to predict ISR (Q2:OR 0.762,95％ CI:0.189-3.062,P =0.762;Q3:OR =2.782,95％ CI:0.865-8.954,P=0.086;and Q4:OR =3.849,95％ CI:1.225 12.097,P =0.021,respectively;P for trend ＜0.0001).Conclusion:PDW is an independent predictor of ISR in patients with CAD and T2DM.