Study Of Coronary Artery Revascularization And Clinical Features In CHD Patient Underwent Coronary Artery Stents Implantation

Background:The proportion of interventional treatment in patients with coronary heart disease is increasing when the morbidity of coronary heart disease is continuous increased. Bare metal stents were gradually replaced by drug eluting stents. Drug eluting stent significantly reduced the rate of in-stent restenosis. In real world, a large amout of revascularization was found in patients with coronary heart disease induced by in-stent restenosis or progression of non-target lesions. For coronary artery revascularization risk factors and predictors, there is still no coronary angiographic follow-up study in domestic by now. This study was designed to retrospectively investigate the coronary artery revascularization (target and non-target lesion revascularzation)and clinical features in patients of coronary heart disease underwent coronary artery stents implantation.Method:A total of544patients who underwent coronary artery stents implantation and received a coronary angiography follow-up (13.0±3.7) in Sir Run Run Shaw Hospital were included in the study. Patients were divided into four groups according to the type of revascularization:Ninty-one cases for non-target lesion revascularization group, fifty-three cases for target lesion revascularization group, and three hundred ninety-seven cases for non-revascularization group (control group), three cases for target lesion and non-target lesion revascularization group. Because the target lesion and non target lesion revascularization group and only had three patients, not included in the statistics.The baseline levels of the first three groups of patients, stent coating drug, stent length, minimum diameter of stent, target lesion and non-target lesion features were analyzed. In addition, the characteristics of revascularization were compared between the two revascularization groups.Result:There was no significant difference in baseline clinical characteristics, multi vessel proportion, total length and minimum diameter of stents with three groups of patients. The proportion of paclitaxel coated stent (32.1%and11.8%, P<0.001) and the proportion of true bifurcation lesions (18.9%and6.5%, P=0.005) was higher in target lesion revascularization group than control group. The lipoprotein A levels was higher in non-target lesion revascularization group than in the control group. There was no significant difference between the two revascularization groups’clinical features of coronary revascularization:Non-fatal myocardial infarction (5.7%vs4.4%respectively, P=0.708); unstable angina pectoris (54.7%vs53.8%, P=0.919); stable angina pectoris (39.6%vs41.8%,P=0.802). The age of the target lesion revascularization group was younger than the non-target lesion revascularization group (64±8.3vs68.1±6.1years, P=0.002),but there was no significant difference in the revascularization time after the first time PCI between the two groups(12.2±4.1and13±3.8,P=0.196). Conclusion:Logistic regression analysis showed that:paclitaxel eluting stent (OR3.78,95%CI1.94-7.35, P<0.001), true bifurcation lesions (OR3.73,95%CI1.64-8.47, P=0.002) were independent predictors of the target lesion revascularization; apolipoprotein A levels (OR1.012,95%CI1.003-1.021, P=0.010),previous myocardial infarction (OR1.916,95%CI1.02-3.61, P=0.044) were independent predictors of the non-target lesion revascularization. The clinical features had no statistical difference between the two revascularzation groups, the target lesion revascularization group was younger than the non-target lesion revascularization group.