Abstract 2565: Progression Of Untreated Nonculprit Coronary Lesions : Long-term Clinically- Driven PCI Rate And Associated Independent Predictors
Objective and Back ground After successful PCI, unpredictable coronary events occur that are caused by both in-stent restenosis and progression of preexisting nonculprit coronary lesions. But there has been no report about the long-term clinically-driven PCI rate for progression of untreated nonculprit coronary lesions and it’s independent predictors including several biomarkers.
Method We reviewed a clinical and angiographic data of 1395 PCI patients from January,2004 to May,2007. Of 1395 PCI patients, 507 patients underwent additional PCI. Of 507 patients, 81(16%)patients underwent clinically-driven PCI of nonculprit coronary lesion(= PCI group)discovered during baseline PCI and 426 (84%)patients did not underwent PCI.(= non-PCI group) And we evaluated the time taken from a baseline PCI to an additional PCI to identity cumulative PCI rate.
Results Cumulative rate of clinically-driven PCI for progression of nonculprit coronary lesions was 7.3%(n=37) by 1yr, 13.4%(n=68) by 2yr and 16%(n=81) by 3yr. Baseline characteristics showed that PCI group had more prior PCI history(22% vs 6%,p<0.001), higher mean TG level(176.15mg/dl vs 147.88mg/dl, p=0.03),more significant multivessel CAD [≥2vessel disease, diameter stenosis ≥50%, (80.5% vs 49.2%, p<0.001)] than non-PCI group at the time of baseline PCI. Type B2/C lesion of an PCI group was only 8.7% at baseline PCI, however, it was 72.8% at nonculprit lesion PCI. The independent predictors of additional clinically-driven PCI were the number of significant coronary lesion at baseline PCI(OR: 2.293, 95%CI, 1.50 –3.50, p<0.001), prior PCI history (OR:1.236, 95%CI, 1.091–1.609,p=0.003), high TG level(OR: 1.005, 95%CI, 1.002–1.007, p=0.038), hypercholesterolemia [>200mg/dl,(OR: 1.461,95%CI, 1.220 –1.965,p=0.04) ],low HDL [<40mg/dl,(OR: 2.006, 95%CI,1.01–3.98,p=0.046) ].
Conclusion Untreated nonculprit coronary lesion can progress requiring subsequent PCI at the rate of 7.3% by 1yr, 13.4% by 2yr and 16% by 3yr.