Coronary artery calcification as a new predictor of non-target lesion revascularization during the chronic phase after successful percutaneous coronary intervention

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• 作者：Yohsuke Honda (1)
  Takuji Toyama (1)
  Yusuke Miyaishi (1)
  Hakuken Kan (1)
  Ren Kawaguchi (1)
  Hitoshi Adachi (1)
  Hiroshi Hoshizaki (1)
  Shigeru Oshima (1)
  
• 关键词：Coronary artery calcification ; Non ; target lesion revascularization ; Abnormal glucose tolerance
• 刊名：Cardiovascular Intervention and Therapeutics
• 出版年：2014
• 出版时间：October 2014
• 年：2014
• 卷：29
• 期：4
• 页码：315-323
• 全文大小：500 KB
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• 作者单位：Yohsuke Honda (1)
  Takuji Toyama (1)
  Yusuke Miyaishi (1)
  Hakuken Kan (1)
  Ren Kawaguchi (1)
  Hitoshi Adachi (1)
  Hiroshi Hoshizaki (1)
  Shigeru Oshima (1)
  
  1. Gunma Prefectural Cardiovascular Center, 3-12, Kameizumi-machi, Maebashi, Gunma, 371-0004, Japan
  
• ISSN：1868-4297

文摘

In the drug-eluting stent era, the outcome of patients undergoing percutaneous coronary intervention (PCI) has remarkably improved. Nevertheless, non-target lesion revascularization (non-TLR) is often performed even after successful PCI and optimized medical therapy. This study aimed to determine the predictor of non-TLR. In all, 125 consecutive patients with stable angina pectoris underwent intravascular ultrasound (IVUS)-guided PCI and were followed up for 3.3?±?0.5?years. We performed oral glucose-tolerance tests in patients with no history of known diabetes mellitus (DM) to investigate glucose tolerance. To evaluate the severity of coronary artery calcification (CAC), we calculated CAC score by multiplying the arc (degree) with the length (mm) of the superficial calcium deposit detected by IVUS. Fourteen patients underwent non-TLR (non-TLR group); the remaining 111 did not (reference group). Glycosylated hemoglobin (HbA1c; %) and prevalence of known DM were similar in both groups, but the non-TLR group had higher fasting blood glucose (103?±?16 vs. 94?±?11?mg/dl, p?=?0.04) and blood glucose (196?±?60 vs. 149?±?48?μU/ml, p?=?0.01) and insulin at 2?h (184?±?241 vs. 67?±?49?μU/ml, p?p?=?0.01). Multiple logistic analysis indicated that CAC score is an independent predictor of non-TLR (p?=?0.008). Non-TLR-free rate was significantly higher for patients with CAC score ?00 than for those with CAC score p?=?0.01). Non-TLR is associated with abnormal glucose tolerance and CAC score; CAC score is an independent predictor of non-TLR. Secondary prevention is especially important in patients with high CAC scores.