# Clinical Predictors of the Rapid Progression and Revascularization of Coronary Non-Target Lesions: A Serial Angiographic Study

## TL;DR

This study identifies clinical factors that predict rapid progression and revascularization of coronary non-target lesions, which can help prevent future cardiovascular events.

## Contribution

The study provides new clinical predictors for rapid progression and revascularization of non-target coronary lesions.

## Key findings

- Hypertension, STEMI, glycosylated hemoglobin, and lesion classification predict rapid lesion progression.
- Triglyceride levels and lesion classification predict lesion revascularization.
- Patients with these factors should receive increased attention to prevent cardiovascular events.

## Abstract

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.

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.

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.

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.