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Cardiovascular Intervention and Therapeutics

, Volume 29, Issue 4, pp 315–323 | Cite as

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

  • Yohsuke Honda
  • Takuji Toyama
  • Yusuke Miyaishi
  • Hakuken Kan
  • Ren Kawaguchi
  • Hitoshi Adachi
  • Hiroshi Hoshizaki
  • Shigeru Oshima
Original Article

Abstract

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 < 0.01) than did the reference group. CAC score was significantly higher in the non-TLR group (788 ± 585 vs. 403 ± 466, 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 ≥400 than for those with CAC score <400 (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.

Keywords

Coronary artery calcification Non-target lesion revascularization Abnormal glucose tolerance 

Notes

Conflict of interest

None.

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2014

Authors and Affiliations

  • 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. 1.Gunma Prefectural Cardiovascular CenterMaebashiJapan

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