Predictors of Progression of Coronary Atherosclerosis after Percutaneous Coronary Intervention

Open access


Objective: This study investigated predictors of progression of coronary atherosclerosis after percutaneous coronary intervention. Their identification may be useful in clinical practice. Methods: We retrospectively reviewed the database of the Cardiology Department of the Cardiovascular Disease and Heart Transplant Institute in Tirgu Mures from January 2012 to December 2015 and identified 180 patients readmitted after successful percutaneous coronary intervention. The t-test, chi-square test, Fisher’s exact test, and mono- and multivariate analyses were used to evaluate associations between the patients’ clinical and angiographic characteristics and the progression of coronary atherosclerosis. Results: The pre-percutaneous coronary intervention atherosclerotic burden was associated with a higher number of new coronary lesions at readmission. Hypertension and the placement of more than one bare-metal stent in the right coronary artery were associated with increased odds of the progression of coronary atherosclerosis. The use of drug-eluting stents at the index percutaneous coronary intervention and a greater number of drug-eluting stents in the left anterior descending artery were associated with a decreased chance of the progression of coronary atherosclerosis. Conclusions: A massive atherosclerotic load at index percutaneous coronary intervention and hypertension were predictors of the progression of coronary artery atherosclerosis. The number, type, and localisation of the stent at the index percutaneous intervention could influence the progression of coronary atherosclerosis. Further research is needed to identify other potential predictors and to determine how to optimize the treatment of known predictors.

1. Bønaa K, Mannsverk J, Wiseth R, et al. - Drug-eluting or bare-metal stents for coronary artery disease. N Engl J Med. 2016;375:1242-1252.

2. Kaneko H, Yajima J, Oikawa Y, et al. - Long-term incidence and prognostic factors of progression of new coronary lesions in Japanese coronary artery disease patients after percutaneous coronary intervention. Heart Vessels. 2014;29:437-442.

3. Park MW, Seung KB, Kim PJ, et al. - Long-term percutaneous coronary intervention rates and associated independent predictors for progression of nonintervened nonculprit coronary lesions. Am J Cardiol. 2009;104:648-652.

4. Sipahi I, Tuzcu EM, Schoenhagen P, et al. - Effects of normal, prehypertensive, and hypertensive blood pressure levels on progression of coronary atherosclerosis. J Am Coll Cardiol. 2006;48:833-838.

5. Borges JC, Lopes N, Soares PR, et al. - Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery. J Cardiothorac Surg. 2010;5:91.

6. Boden WE, O’Rourke RA, Teo KK, et al. - Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1503-1516.

7. Ellis SG, Stone GW, Cox DA, et al. - Long-term safety and efficacy with paclitaxel-eluting stents: 5-year final results of the TAXUS IV clinical trial (TAXUS IV-SR: treatment of de novo coronary disease using a single paclitaxel-eluting stent). JACC Cardiovasc Interv. 2009;2:1248-1259.

8. Bangalore S, Kumar S, Fusaro M, et al. - Short- and long-term outcomes with drug-eluting and bare-metal coronary stents: a mixedtreatment comparison analysis of 117 762 patient-years of follow-up from randomized trials. Circulation. 2012;125:2873-2891.

9. Zellweger MJ, Kaiser C, Jeger R, et al. - Coronary artery disease progression late after successful stent implantation. J Am Coll Cardiol. 2012;59:793-799.

10. Alderman EL, Corley SD, Fisher LD, et al. - Five-year angiographic follow-up of factors associated with progression of coronary artery disease in the coronary artery surgery study (CASS). CASS participating investigators and staff. J Am Coll Cardiol. 1993;22:1141-1154.

11. Lichtlen PR, Nikutta P, Jost S, et al. - Anatomical progression of coronary artery disease in humans as seen by prospective, repeated, quantitative coronary angiography. Relation to clinical events and risk factors. The INTACT Study Group. Circulation. 1992;86:828-838.

12. Fox KM, EURopean trial On reduction of cardiac events with Perindopril in stable Artery disease Investigators - Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet. 2003;362:782-788.

13. Gude D - Angiotensin-converting enzyme inhibitors in lipid metabolism and atherosclerosis: An ace up the sleeve? J Sci Soc. 2014;41;59-60.

Acta Medica Marisiensis

The Journal of The University of Medicine and Pharmacy of Targu-Mures

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 71 71 12
PDF Downloads 36 36 7