Predictors for rapid progression of non-culprit coronary lesions after successful stent implantation in culprit lesions

doi:10.3969/j.issn.1006-7795.2013.01.017

Abstract

Abstract:

Objective The majority of cardiovascular events in patients undergoing percutaneous coronary interventions (PCI) arise from the progression of non-culprit coronary lesions (NCL) during the follow-up period. The purpose of this study was to investigate the predictors related to the rapid progression of NCL of patients undergoing PCI. Methods Between Jan. 2006 and Apr 2011, 170 consecutive patients who underwent coronary angiograms again with a time interval from 1 to 12 months after successful stent implantation at culprit-lesion. The patients were divided into rapid progression group (n=49) and slow progression group (n=121) according to definition of rapid progression. Results Twenty-eight percent of patients had rapid progression of non- lesions. Rapid progressors had higher percentage of multivessel diseases and statin therapy. At follow-up, a significant difference was observed between rapid progression group and slow progression group in triglyceride (TG) (2.02 vs 1.59 mmol/L, P=0.020), total cholesterol (TC) (4.25 vs 3.79 mmol/L, P=0.013), and change of TC (-0.80 vs -1.25 mmol/L, P=0.03), low-density lipoprotein cholesterol (LDL-C) (2.42 vs 2.16 mmol/L, P=0.03) and change of LDL-C (-0.39 vs -0.75 mmol/L, P=0.020). Multivariate Logistic regression analysis revealed that multivessel diseases, on-treatment for TG, change of LDL-C, rate of in-stent restenosis and rate of statin therapy were independent predictors for rapid progression. Conclusion Multivessel diseases, on-treatment for TG, change of LDL-C, rate of in-stent restenosis and rate of statin therapy were associated with the rapid progression of non- coronary lesion. This finding highlights the need for intensive statins therapy in patients with coronary artery disease after successful PCI.

Key words: non-culprit coronary lesions, rapid progression, coronary heart disease

CLC Number:

R541.4

CHEN Wenming, LI Dongbao, CHEN Hui, LI Hongwei, ZHAO Jie, ZHAO Huiqiang, LIANG Siwen, DING Xiaosong. Predictors for rapid progression of non-culprit coronary lesions after successful stent implantation in culprit lesions[J]. Journal of Capital Medical University, 2013, 34(1): 90-94.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.01.017

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I1/90

References

[1] Glaser R, Selzer F, Faxon D P, et al.Clinical progression of incidental, asymptomatic lesions discovered during culprit vessel coronary intervention[J]. Circulation, 2005,111(2):143-149.

[2] Park M W, Seung K B, Kim P J, et al. Long-term percutaneous coronary intervention rates and associated independent predictors for progression of on-intervened nonculprit coronary lesions[J]. Am J Cardiol, 2009, 104(5):648-652.

[3] Zouridakis E G, Schwartzman R, Garcia-Moll X, et al. Increased plasma endothelin levels in angina patients with rapid coronary artery disease rogression[J]. Eur Heart J, 2001, 22(17): 1578-1584.

[4] Zouridakis E, Avanzas P, Arroyo-Espliguero R, et al.Markers of inflammation and rapid coronary artery disease progression in patients with stable angina pectoris[J]. Circulation, 2004,110(13): 1747-1753.

[5] Tsiamis E, Toutouzas K, Synetos A, et al.Prognostic clinical and angiographic characteristics for the development of a new significant lesion in remote segments after successful percutaneous coronary intervention[J]. Int J Cardiol, 2010,143(1):29-34.

[6] Moise A, Theroux P, Taeymans Y, et al. Clinical and angiographic factors associated with progression of coronary artery disease[J]. J Am Coll Cardiol, 1984,3(13):659-667.

[7] Kaski J C, Chester M R, Chen L, et al. Rapid angiographic progression of coronary artery disease in patients with angina pectoris.The role of complex stenosis morphology[J]. Circulation, 1995, 92(8):2058-2065.

[8] Stone G W, Maehaza A, Lansky A J, et al. A prospective natural-history study of coronary atherosclerosis[J].N Engl J Med,2011,364(3):226-235.

[9] Davies S W, Marchant B, Lyons J P, et al. Irregular coronary lesion morphology after thrombolysis predicts early clinical instability[J]. J Am Coll Cardiol, 1991,18(13):669-674.

[10] Ballantyne C M, Olsson A G, Cook T J, et al.Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S[J].Circulation,2001, 104(25):3046-3051(7).

[11] Miller M, Cannon C P, Murphy S A, et al. Impact of triglyceride levels beyond low-density lipoprotein cholesterol after acute coronary syndrome in the PROVE IT-TIMI 22 Trial[J]. J Am Coll Cardiol, 2008,51:724-730.

[12] Hodis H N, MacK W J, Azen S P, et al.Triglyceride-and cholesterol-rich lipoproteins have a differential effect on mild/moderate and severe lesion progression as assessed by quantitative coronary angiography in a controlled trial of Lovastatin[J]. Circulation, 1994, 90(1):42-49.

[13] Yin Z X, Zhou Y J, Liu X L,et al.Clinical predictors for progression of nonintervened nonculprit coronary lesions despite low-density lipoprotein cholesterol less than 1.8 mmol/L after successful stent implantation[J].Coron Artery Dis,2011, 22(1):49-54.

[1]	Xia Ning, Nie Xiuhong, Wang Hao, Fan Xiaojun. Association of OSA and asthma with the incidence rate of coronary heart disease [J]. Journal of Capital Medical University, 2022, 43(1): 138-142.
[2]	Xu Xiaohan, Cheng Yujing, Liu Xiaoli, Zhou Yujie. Guardian of the heart——Professor Zhou Yujie [J]. Journal of Capital Medical University, 2020, 41(5): 844-848.
[3]	Wei Jiajie, Jiao Jie, Zhou Yingsheng. Clinical characteristics and risk factors of obstructive sleep apnea syndrome in patients with type 2 diabetes mellitus [J]. Journal of Capital Medical University, 2020, 41(1): 35-39.
[4]	Xiong Xiaowei, Guo Caixia, Xu Xiaowei, Mu Liying, Hu Hongyu, Chen Wei, Chen Buxing. Associations of plasma trimethylamine N-oxide and its precursors with coronary heart disease [J]. Journal of Capital Medical University, 2020, 41(1): 99-102.
[5]	Xia Yong, Zhang Jianqing, Wang Shaoxia, Chen Dan, Ji Jianmin. Effects of combined sacubitril/valsartan and metoprolol succinate sustained release tablets on patients who suffer from the coronary heart disease with chronic heart failure [J]. Journal of Capital Medical University, 2020, 41(1): 113-118.
[6]	Yang Yaoguo, Chen Zhong, Tang Xiaobin, Kou Lei, Wu Zhangmin, Liu Hui, Wang Sheng, Zhang Zheng, Jia Yunfeng, He Nan. Clinical characteristics and perioperative management of abdominal aortic aneurysm complicated with coronary heart disease [J]. Journal of Capital Medical University, 2015, 36(1): 23-27.
[7]	NAN Nan;JIN Ze-ning;YANG Ze. Genetic association of ADIPOQ gene polymorphisms with type 2 diabetes mellitus with coronary artery disease [J]. Journal of Capital Medical University, 2012, 33(4): 421-426.
[8]	MA Ya-hong;XIAN Xun-de;YANG Jun-fen;ZHEN Ya-ping;LIU Guo-qing;YANG Jin-kui. Characteristics of HDL2b changes and their significance in prediction of risks for coronary artery disease in type 2 diabetic patients [J]. Journal of Capital Medical University, 2011, 32(5): 609-613.
[9]	FAN Xin;Wei Xin;Du Feng-he. Role of Adhesion Molecules in the Relationship between Obstructive Sleep Apnea-hypopnea Syndrome and Coronary Heart Disease [J]. Journal of Capital Medical University, 2009, 30(5): 687-690.
[10]	HONG Xu;MA Qing;CHEN Hai-ping;YU Heng-chi;YIN Jie;HAO Ya-bin. Clinical Characteristics of the Elderly with Metabolic Syndrome [J]. Journal of Capital Medical University, 2009, 30(5): 691-695.
[11]	Fan Xin;Du Fenghe. Role of C-reactive Protein in the Relationship between Obstructive Sleep Apnea-hypopnea Syndrome and Coronary Heart Disease [J]. Journal of Capital Medical University, 2009, 30(1): 89-92.
[12]	Wang Yanling;Cui Wei;Hua Qi;Xu Dong. Relationship of Serum Ferritin,Oxidized Low Density Lipoprotein and Total Bilirubin in Patients with Coronary Heart Disease [J]. Journal of Capital Medical University, 2008, 29(6): 754-757.
[13]	Gao Jing;Hua Qi;Wang Cairong;Li Xiaohui;Gao Chengmei. Evaluation of Left Ventricular Function of Patients with Coronary Heart Disease by Using Real Time Three Dimensional Echocardiography [J]. Journal of Capital Medical University, 2008, 29(4): 487-489.
[14]	Chen Keji;Xue Mei;Yin Huijun. The Relationship between Platelet Activation and Coronary Heart Disease and Blood-stasis Syndrome [J]. Journal of Capital Medical University, 2008, 29(3): 266-269.
[15]	Xie Ying;Li Xi;Tian Yuxian;Jiang Zhaohui. Effect of Simvastatin on Lipids and Lipid Ratios of the Elderly Patients with Coronary Heart Disease [J]. Journal of Capital Medical University, 2006, 27(4): 501-503.