Percutaneous coronary intervention as an independent predictor of non-target lesion progression in 1658 patients with coronary artery disease

经皮冠状动脉介入治疗作为1658例冠状动脉疾病患者非靶病变进展的独立预测因子

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Abstract

Rationale: Non-target lesions (NTLs) progression is common in patients with coronary artery disease (CAD). However, its predictors remain obscure. Methods: An angiographic study was conducted in patients with CAD who underwent coronary angiography twice at an interval of 6 to 30 months. NTLs were defined as lesions not treated with percutaneous coronary intervention (PCI) during the first hospitalization. A stenosis index (SI) was calculated from all NTLs in each patient. NTLs progression was defined as an increase in SI (ΔSI > 0) at follow-up. Results: Among 1658 patients recruited, 1061 (64.0%) exhibited NTL progression, with a ΔSI of 0.75 (0.40, 1.30) over a mean follow-up period of 13 months. The NTLs progression group had more males, diabetics, higher neutrophil ratio, creatinine, fasting blood glucose (FBG), uric acid, more PCI therapy and higher SI on the first admission, and higher systolic blood pressure, heart rate, serum levels of low-density lipoprotein cholesterol and FBG at readmission. Multiple logistic regression analysis identified male sex, PCI therapy, and SI on the first admission, and FBG on the second admission were independent predictors of NTLs progression, with the odds ratio of 1.390 (95%CI 1.034~1.869), 1.375 (95%CI 1.087~1.740), 1.003 (95%CI 1.002~1.004) and 1.184 (95% CI 1.086~1.291), respectively. Conclusions: Over 60% of CAD patients developed NTL progression within 30 months. Male sex, PCI therapy and SI on the first admission, and FBG on the second admission were independent predictors of NTLs progression.

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