Angiographic and Clinical Predictors of Non-Culprit Coronary Lesion Progression after Percutaneous Coronary Intervention in Patients with STElevation Myocardial Infarction.

Elawady, Waleed Salim; Elmenshawy, Mahmoud Diaa; Masoud, Masoud Mohamed; Shehata, Islam Elsayed Mohammed

Background: Most of cardiovascular (CV) events in patients of STelevation myocardial infarction (STEMI) with undergoing primary percutaneous coronary intervention (PPCI) are linked to the progression of non-culprit coronary lesions (NCCLs) during the follow-up period. Yet, the clinical and angiographic risk factors of non-culprit coronary lesion (NCCL) progression are not well known. So this study was aimed to assess the clinical risk profile and angiographic features that can be related to the progression of mild NCCLs (<50% stenosis) of patients with STEMI and undergoing PCI over 24 months duration. Methods: The present cohort study evaluated 200 patients with STEMI underwent PCI to the culprit lesion and have mild, non-culprit lesion (NCL) <50% stenosis. Patients were divided into 2 groups; Non progressed group: 157 patients with non-progressed NCLs. Progressed group: 43 patients who needed additional PCI to progressed NCLs. Results: In a multivariate logistic regression analysis, independent predictors of NCLs progression included the age (odds ratio [OR]:0.854, 95% confidence interval [CI]: 0.775 to 0.941; p=0.001), C-reactive protein (CRP) (OR:1.670, 95% CI: 1.255 to 2.223; p < 0.001), non-targeted low density lipoprotein cholesterol (LDL-C) with follow up (>1.4mmol/L) (OR:14.030, 95% CI: 2.766 to 71.155; p= 0.001), Complex culprit lesion (OR:47.249, 95% CI: 4.925 to 453.290; p = 0.001), and presence of more than one NCL (OR:27.090, 95% CI: 4.213 to 174.179; p= 0.001). Conclusions: The underlying clinical and angiographic characteristics can predict NCLs progression. Complex morphology of culprit lesion is the strongest independent predictor for progression of NCLs.

Zagazig University Medical Journal, 2024, Vol 30, p183

1110-1431

Academic Journal

10.21608/ZUMJ.2021.63229.2135