Abstract：
BACKGROUND: Percutaneous coronary intervention (PCI) has become the primary treatment for coronary artery disease. However, while PCI effectively addresses severe stenosis or occlusive lesions in target vessels, the progression of non-target vessel plaque remains a critical determinant of long-term patient prognosis.
OBJECTIVE: The purpose of this study was to investigate the impact of non-target vascular plaque progression on prognosis after PCI for ISR.
METHODS: This study included 195 patients diagnosed with ISR and multivessel disease who underwent successful PCI with drug-eluting stent (DES) placement, along with intraoperative optical coherence tomography (OCT) assessment of the culprit stent. Subsequent rechecked coronary angiography categorized eligible patients into non-target lesion progression (N-TLP) and no-N-TLP groups. We evaluated the baseline morphological characteristics of N-TLP by OCT and investigated the relationship between N-TLP, non-culprit vessel-related major adverse cardiovascular events (NCV-MACE), and pan-vascular disease-related clinical events (PVD-CE) incidence.
RESULTS: Multivariate logistic regression analysis revealed that diabetes mellitus (OR 3.616, 95% CI: 1.735-7.537; P = 0.001), uric acid level (OR 1.005, 95% CI: 1.001-1.009; P = 0.006), in-stent neoatherosclerosis (ISNA) (OR 1.334, 95% CI: 1.114-1.985; P = 0.047) and heterogeneous neointima morphology (OR 2.48, 95% CI: 1.18-5.43; P = 0.019) were independent predictors for N-TLP. Furthermore, N-TLP was associated with a high incidence of NCV-MACE (19.4% vs 6.9%, P = 0.009) and PVD-CE (83.9% [95% CI: 79.7%-88.3%] vs 93.1% [95% CI: 88.4%-98.0%], P = 0.038) after PCI in ISR patients.
CONCLUSIONS: Diabetes, uric acid levels, ISNA, and heterogeneous neointima are predictive factors for subsequent rapid plaque progression, with N-TLP exacerbating the incidence of NCV-MACE and PVD-CE after PCI.
OBJECTIVE: The purpose of this study was to investigate the impact of non-target vascular plaque progression on prognosis after PCI for ISR.
METHODS: This study included 195 patients diagnosed with ISR and multivessel disease who underwent successful PCI with drug-eluting stent (DES) placement, along with intraoperative optical coherence tomography (OCT) assessment of the culprit stent. Subsequent rechecked coronary angiography categorized eligible patients into non-target lesion progression (N-TLP) and no-N-TLP groups. We evaluated the baseline morphological characteristics of N-TLP by OCT and investigated the relationship between N-TLP, non-culprit vessel-related major adverse cardiovascular events (NCV-MACE), and pan-vascular disease-related clinical events (PVD-CE) incidence.
RESULTS: Multivariate logistic regression analysis revealed that diabetes mellitus (OR 3.616, 95% CI: 1.735-7.537; P = 0.001), uric acid level (OR 1.005, 95% CI: 1.001-1.009; P = 0.006), in-stent neoatherosclerosis (ISNA) (OR 1.334, 95% CI: 1.114-1.985; P = 0.047) and heterogeneous neointima morphology (OR 2.48, 95% CI: 1.18-5.43; P = 0.019) were independent predictors for N-TLP. Furthermore, N-TLP was associated with a high incidence of NCV-MACE (19.4% vs 6.9%, P = 0.009) and PVD-CE (83.9% [95% CI: 79.7%-88.3%] vs 93.1% [95% CI: 88.4%-98.0%], P = 0.038) after PCI in ISR patients.
CONCLUSIONS: Diabetes, uric acid levels, ISNA, and heterogeneous neointima are predictive factors for subsequent rapid plaque progression, with N-TLP exacerbating the incidence of NCV-MACE and PVD-CE after PCI.
摘要：
背景：经皮冠状动脉介入治疗（PCI）已成为冠状动脉疾病的主要治疗方法。然而,PCI可有效解决靶血管的严重狭窄或闭塞性病变，非靶血管斑块的进展仍是患者长期预后的关键决定因素.
目的：本研究的目的是探讨非靶血管斑块进展对ISRPCI术后预后的影响。
方法：这项研究包括195例诊断为ISR和多支血管病变的患者，这些患者通过药物洗脱支架（DES）置入成功进行了PCI，术中光学相干断层扫描（OCT）评估罪犯支架。随后重新检查的冠状动脉造影将符合条件的患者分为非靶病变进展（N-TLP）和非N-TLP组。我们通过OCT评估了N-TLP的基线形态特征，并研究了N-TLP之间的关系。非罪犯血管相关主要不良心血管事件（NCV-MACE），和泛血管疾病相关临床事件（PVD-CE）的发生率。
结果：多因素logistic回归分析显示糖尿病（OR3.616，95％CI：1.735-7.537；P=0.001），尿酸水平（OR1.005，95%CI：1.001-1.009；P=0.006），支架内新动脉粥样硬化(ISNA)(OR1.334,95%CI:1.114-1.985;P=0.047)和异质性新内膜形态(OR2.48,95%CI:1.18-5.43;P=0.019)是N-TLP的独立预测因子.此外，N-TLP与NCV-MACE的高发生率相关(19.4%vs6.9%,P=0.009）和PVD-CE（83.9%[95%CI：79.7%-88.3%]vs93.1%[95%CI：88.4%-98.0%]，P=0.038）在ISR患者PCI术后。
结论：糖尿病，尿酸水平,ISNA,和异质性新内膜是随后快速斑块进展的预测因素，N-TLP加重PCI术后NCV-MACE和PVD-CE的发生率。
目的：本研究的目的是探讨非靶血管斑块进展对ISRPCI术后预后的影响。
方法：这项研究包括195例诊断为ISR和多支血管病变的患者，这些患者通过药物洗脱支架（DES）置入成功进行了PCI，术中光学相干断层扫描（OCT）评估罪犯支架。随后重新检查的冠状动脉造影将符合条件的患者分为非靶病变进展（N-TLP）和非N-TLP组。我们通过OCT评估了N-TLP的基线形态特征，并研究了N-TLP之间的关系。非罪犯血管相关主要不良心血管事件（NCV-MACE），和泛血管疾病相关临床事件（PVD-CE）的发生率。
结果：多因素logistic回归分析显示糖尿病（OR3.616，95％CI：1.735-7.537；P=0.001），尿酸水平（OR1.005，95%CI：1.001-1.009；P=0.006），支架内新动脉粥样硬化(ISNA)(OR1.334,95%CI:1.114-1.985;P=0.047)和异质性新内膜形态(OR2.48,95%CI:1.18-5.43;P=0.019)是N-TLP的独立预测因子.此外，N-TLP与NCV-MACE的高发生率相关(19.4%vs6.9%,P=0.009）和PVD-CE（83.9%[95%CI：79.7%-88.3%]vs93.1%[95%CI：88.4%-98.0%]，P=0.038）在ISR患者PCI术后。
结论：糖尿病，尿酸水平,ISNA,和异质性新内膜是随后快速斑块进展的预测因素，N-TLP加重PCI术后NCV-MACE和PVD-CE的发生率。
