Objective:To explore the factors affecting the positive remodeling of target vessels in orthotopic coronary artery lesions after drug coated balloon(DCB)treatment.Methods:A retrospective analysis was performed on clin-ical data of 130 patients who received DCB treatment for orthotopic coronary artery lesions in our hospital from June 2019 to June 2021 and underwent intravascular ultrasound(IVUS)or optical coherence tomography(OCT)to review the coronary target vessels after discharge.According to coronary target vessel condition,the patients were divided into positive remodeling group(n=57)and negative remodeling group(n=73).Multivariate Logistic re-gression was used to analyze the factors affecting positive remodeling of target vessels in patients with orthotopic coronary artery lesions after DCB treatment.Results:Compared with negative remodeling group,there were sig-nificant rise in percentages of male(74.0%vs.89.5%),usage of scoring balloon(31.5%vs.49.1%),right coro-nary or posterior descending left ventricular posterior branch lesions(11.0%vs.28.1%),annual income>100000 RMB(19.2%vs.35.1%),exercise frequency ≥5 times/week(6.8%vs.64.9%),minimum lumen diameter dur-ing follow-up[(2.22±0.87)mm vs.(2.95±0.34)mm]and in-hospital fee[70218.42(51461.18,96114.17)RMB vs.91003.74(61930.16,116948.25)RMB],and significant reductions in percentages of smoking history(67.1%vs.38.6%)and poor sleep quality(86.3%vs.22.8%)in positive remodeling group,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that exercise frequency ≥3 times/week,good sleep quality and usage of scoring/cutting balloon were independent protective factors for positive remodeling of target vessels af-ter DCB treatment in these patients(OR=0.014~0.097,P<0.01 all),while smoking history was its independent risk factor(OR=3.970,P=0.047).Conclusion:Smoking history is an independent risk factor for positive remode-ling of target vessels in orthotopic coronary artery lesions after DCB treatment,while exercise frequency≥3 times/week,good sleep quality and usage of scoring/cutting balloon are its independent protective factors.