Abstract 565: Clinical Profiles of Rapid Progression of Coronary Artery Lesions From Mild to Severe Stenosis during a Short-Term Period
The process of coronary plaque progression and instability in coronary artery disease (CAD) remain unclear. We aimed to assess the rapid progression of coronary artery lesions from mild to severe stenosis within 1 year.
Methods and result: Among the 574 patients in whom 2 serial coronary angiograms were performed within 1 year during culprit vessel coronary intervention, 40 patients (6.9%) required additional nontarget lesion PCI for rapid coronary plaque progression (8.6±1.8months). Percent stenosis significantly increased from 23.8 ± 10.8% to 80.8 ± 8.4% (P<0.001). Forty-three percent (17 of 40 patients) presented with new unstable angina, and 12.5% (5 of 40 patients) presented with nonfatal myocardial infarction (MI). Multivessel CAD, previous MI (75% vs 16.7%, p<0.0001), younger age (62.8±13.1 vs 67.7±10.6 years, p=0.006), and higher hs-CRP (0.27 ± 0.17 vs 0.18 ± 0.15 mg/dl, p=0.0005) were significantly more observed in patients with rapid plaque progression. In a multivariable logistic regression analysis, multivessel CAD (chi-square=23.2; p<0.0001), hs-CRP (chi-square=16.2; p<0.0001), and previous MI (chi-square=5.29; p<0.0214) were significantly independent predictors for rapid coronary plaque progression.
Conclusion: Approximately 7% of CAD patients will have rapid coronary plaque progression within 1 year. An inflammatory biological profile and greater coronary artery disease burden will provide information to identify subclinical high-risk plaques in vulnerable patients.