PDF(Pubmed)
Abstract：
UNASSIGNED: Rapid progression of coronary non-target lesions is essential for the determination of future cardiovascular events. Clinical factors that predict rapid progression of non-target lesions are unclear. The purpose of this study was to identify the clinical predictors of rapid progression and revascularization of coronary non-target lesions.
UNASSIGNED: Consecutive patients with coronary heart disease who had undergone two serial coronary angiograms were enrolled. All coronary non-target lesions were identified and evaluated at both procedures. Multivariable Cox regression analysis was used to investigate the clinical risk factors associated with rapid progression or revascularization of coronary non-target lesions.
UNASSIGNED: A total of 1255 patients and 1670 lesions were enrolled. In this cohort of patients, 239 (19%) had rapid progression and 186 (14.8%) underwent revascularization. At the lesion level, 251 (15.0%) had rapid progression and 194 (11.6%) underwent revascularization. The incidence of lesion revascularization and myocardial infarction was significantly higher in patients with rapid progression. In multivariable analyses, hypertension (hazard ratio [HR], 0.76; 95% confidence interval [95% CI], 0.58-1.00; p = 0.049), ST-segment elevation myocardial infarction (STEMI) (HR, 1.46; 95% CI, 1.03-2.07; p = 0.035), glycosylated hemoglobin (HR, 1.16; 95% CI, 1.01-1.33; p = 0.039) and lesion classification (B2/C versus A/B1) (HR, 1.73; 95% CI, 1.27-2.35; p = 0.001) were significant factors associated with rapid progression. The level of triglycerides (HR, 1.10; 95% CI, 1.00-1.20; p = 0.040) and lesion classification (B2/C versus A/B1) (HR, 1.53; 95% CI, 1.09-2.14; p = 0.014) were predictors of lesion revascularization.
UNASSIGNED: Hypertension, STEMI, glycosylated hemoglobin and lesion classification may be used as predictors of rapid progression of coronary non-target lesions. The level of triglyceride and lesion classification may predict the revascularization of non-target lesions. In order to prevent future cardiovascular events, increased attention should be paid to patients with these factors.
UNASSIGNED: Consecutive patients with coronary heart disease who had undergone two serial coronary angiograms were enrolled. All coronary non-target lesions were identified and evaluated at both procedures. Multivariable Cox regression analysis was used to investigate the clinical risk factors associated with rapid progression or revascularization of coronary non-target lesions.
UNASSIGNED: A total of 1255 patients and 1670 lesions were enrolled. In this cohort of patients, 239 (19%) had rapid progression and 186 (14.8%) underwent revascularization. At the lesion level, 251 (15.0%) had rapid progression and 194 (11.6%) underwent revascularization. The incidence of lesion revascularization and myocardial infarction was significantly higher in patients with rapid progression. In multivariable analyses, hypertension (hazard ratio [HR], 0.76; 95% confidence interval [95% CI], 0.58-1.00; p = 0.049), ST-segment elevation myocardial infarction (STEMI) (HR, 1.46; 95% CI, 1.03-2.07; p = 0.035), glycosylated hemoglobin (HR, 1.16; 95% CI, 1.01-1.33; p = 0.039) and lesion classification (B2/C versus A/B1) (HR, 1.73; 95% CI, 1.27-2.35; p = 0.001) were significant factors associated with rapid progression. The level of triglycerides (HR, 1.10; 95% CI, 1.00-1.20; p = 0.040) and lesion classification (B2/C versus A/B1) (HR, 1.53; 95% CI, 1.09-2.14; p = 0.014) were predictors of lesion revascularization.
UNASSIGNED: Hypertension, STEMI, glycosylated hemoglobin and lesion classification may be used as predictors of rapid progression of coronary non-target lesions. The level of triglyceride and lesion classification may predict the revascularization of non-target lesions. In order to prevent future cardiovascular events, increased attention should be paid to patients with these factors.
摘要：
■冠状动脉非靶病变的快速进展对于确定未来的心血管事件至关重要。预测非靶病变快速进展的临床因素尚不清楚。这项研究的目的是确定冠状动脉非靶病变快速进展和血运重建的临床预测因素。
■连续进行两次冠状动脉造影的冠心病患者被纳入研究。在两种程序中都识别并评估了所有冠状动脉非靶病变。采用多变量Cox回归分析探讨冠状动脉非靶病变快速进展或血运重建的临床危险因素。
■共纳入1255例患者和1670个病灶。在这群患者中，239（19％）进展迅速，186（14.8％）进行了血运重建。在病变级别，251例（15.0%）进展迅速，194例（11.6%）接受血运重建。进展迅速的患者，病变血运重建和心肌梗死的发生率明显较高。在多变量分析中，高血压(危险比[HR]，0.76；95%置信区间[95%CI]，0.58-1.00；p=0.049），ST段抬高型心肌梗死（STEMI）（HR，1.46；95%CI，1.03-2.07；p=0.035），糖化血红蛋白（HR，1.16；95%CI，1.01-1.33；p=0.039）和病变分类（B2/C与A/B1）（HR，1.73；95%CI，1.27-2.35；p=0.001）是与快速进展相关的显著因素。甘油三酯的水平(HR，1.10；95%CI，1.00-1.20；p=0.040）和病变分类（B2/C与A/B1）（HR，1.53；95%CI，1.09-2.14；p=0.014）是病变血运重建的预测因子。
■高血压，STEMI,糖化血红蛋白和病变分类可作为冠状动脉非靶病变快速进展的预测因子。甘油三酯水平和病变分类可以预测非靶病变的血运重建。为了预防未来的心血管事件，应更加重视这些因素的患者。
■连续进行两次冠状动脉造影的冠心病患者被纳入研究。在两种程序中都识别并评估了所有冠状动脉非靶病变。采用多变量Cox回归分析探讨冠状动脉非靶病变快速进展或血运重建的临床危险因素。
■共纳入1255例患者和1670个病灶。在这群患者中，239（19％）进展迅速，186（14.8％）进行了血运重建。在病变级别，251例（15.0%）进展迅速，194例（11.6%）接受血运重建。进展迅速的患者，病变血运重建和心肌梗死的发生率明显较高。在多变量分析中，高血压(危险比[HR]，0.76；95%置信区间[95%CI]，0.58-1.00；p=0.049），ST段抬高型心肌梗死（STEMI）（HR，1.46；95%CI，1.03-2.07；p=0.035），糖化血红蛋白（HR，1.16；95%CI，1.01-1.33；p=0.039）和病变分类（B2/C与A/B1）（HR，1.73；95%CI，1.27-2.35；p=0.001）是与快速进展相关的显著因素。甘油三酯的水平(HR，1.10；95%CI，1.00-1.20；p=0.040）和病变分类（B2/C与A/B1）（HR，1.53；95%CI，1.09-2.14；p=0.014）是病变血运重建的预测因子。
■高血压，STEMI,糖化血红蛋白和病变分类可作为冠状动脉非靶病变快速进展的预测因子。甘油三酯水平和病变分类可以预测非靶病变的血运重建。为了预防未来的心血管事件，应更加重视这些因素的患者。
