A nested case-control study of risk factors for non-target lesion progression after percutaneous coronary intervention in patients with coronary artery disease
HAN Guo-dong
YAO kang
WEI Zhi-liang
LIN Peng-yang
YANG Xu-long
LI Dian
LIU Yan
ZGANG Xiao-wei
SUN Shou-gang
Abstract：Objective To explore the risk factors for non-target lesion progression after percutaneous coronary intervention(PCI),and to provide a scientific basis for the prevention and treatment of non-target lesion progression in coronary artery disease.Methods A nested case-control study design was used to prospectively construct a cohort of 1568 patients who underwent PCI and underwent follow-up imaging from January 2020 to April 2023 at the Second Hospital of Lanzhou University.A total of 83 cases with progression of non-target coronary lesions were identified as the progression group,and the control group was matched by propensity score,with 75 cases in the progression group and 150 cases in the control group successfully matched.Non-target lesion data were measured by quantitative coronary angiography(QCA),and independent risk factors associated with non-target lesion progression were identified by multivariate Logistic regression analysis.Results Compared with the control group,the progression group had higher body mass index(BMI)(P<0.001),low-density lipoprotein cholesterol(LDL-C)(P<0.01),platelet(P=0.01)and C-reactive protein(CRP)(P<0.01)levels,and lower high-density lipoprotein cholesterol(HDL-C)(P<0.01),white blood cell(WBC)(P=0.04),indirect bilirubin(P=0.03)and blood glucose levels(P<0.01).Multifactorial Logistic regression analysis showed that BMI(P<0.01),blood glucose(P=0.02),CRP(P=0.04)and WBC(P=0.03)were independent risk factors for non-target lesion progression.Diagnostic tests showed that BMI(P<0.01,AUC=0.68),blood glucose concentration(P=0.02,AUC=0.59)and WBC level(P=0.02,AUC=0.59)had a predictive value for the progression of non-target lesions.Conclusion There is a significant correlation between blood glucose concentration,BMI and CRP,WBC levels and non-target lesion progression after PCI,and strict control of these factors in clinical practice is essential to improve clinical regression in patients with non-target lesion progression.Blood glucose concentration,BMI and WBC levels are predictors of non-target lesion progression after PCI.The findings provide a new perspective on individualised management strategies for patients after PCI for coronary artery disease.
Keywords：Coronary heart diseaseNon-target lesionsPercutaneous coronary interventionRisk factorsNested case-control study
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 260-265 )