Risk Factors of Progression of Non-Culprit Coronary Lesions in Patients after PCI for Coronary Heart Disease
Objective To analyze the factors influencing the progression of non-culprit coronary lesions(NCCLs)after per-cutaneous coronary intervention(PCI)in patients with coronary atherosclerotic heart disease.Methods A total of 171 pa-tients who underwent PCI at the Cardiovascular Disease Diagnosis and Treatment Center of Taihe Hospital in Shiyan City from August 2020 to August 2022 and underwent coronary angiography(CAG)at least every 3 months were selected in this study and assigned into a non-progression group(n=72)and a progression group(n=99)based on the progression of NCCLs or not.The baseline clinical data of the two groups were compared,including general information such as age,gen-der,body mass index(BMI),past medical history,smoking history and medication status.Laboratory examination results were also compared between the two groups,including white blood cells(WBC),C-reactive protein(CRP),fibrinogen(FIB),glycosylated hemoglobin(HbA1c),blood lipids,lipoprotein(LP(a)),serum uric acid(SUA),homocysteine(Hcy),and the differences in blood lipids and Hcy(ΔHcy)between two admissions.In addition,the coronary arteriogra-phy was compared between the two groups.On the basis of the comparison results between the two groups,the factors influ-encing the progression of NCCLs after PCI were analyzed.Results The two groups showed no significant difference in gen-der,age,BMI,hypertension or diabetes(P＞0.05);but a difference in smoking history(P＜0.05).The two groups show-cased differences in HbA1c,Lp(a)UA,ΔHcy and intraoperative stents implanted＞1(all P＜0.05).The results of multi-variate logistic regression analysis showed that the progression of NCCLs after PCI was related to smoking history(OR= 4.031,95%CI:1.655-1.491,P=0.003),LP(a)(OR=1.003,95%CI:1.001-1.006,P=0.008),HbA1c(OR= 2.945,95%CI:1.623-6.175,P=0.001),UA(OR=1.006,95%CI:1.002-1.010,P=0.012),ΔHcy(OR=1.380,95%CI:1.139-1.741,P=0.003)and the number of stents＞1(OR=2.702,95%CI:1.036-7.058,P=0.047).Conclu-sion Smoking history,Lp(a),Δ Hcy,UA,HbA1c,and the number of implanted stents＞1 are independent factors influen-cing the progression of NCCLs(P＜0 05).
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