Changes in non-culprit lesion severity on follow-up coronary angiography after primary percutaneous coronary ıntervention

Abstract

Aim: Non-culprit lesion severity has often been exaggerated at the time of acute ST segment elevation myocardial infarction (STEMI). We aimed to determine changes in non-culprit lesions severity on follow-up coronary angiography (CAG) and independent predictors of these changes. Material and Methods: We retrospectively evaluated the changes in non-culprit lesion stenosis on follow-up CAG which was done within 2 months after primary percutaneous coronary intervention (P-PCI) in patients presenting with STEMI. Results: 154 patients were included in this study and 207 non-culprit lesions (percentage diameter stenosis (PDS) ≥50%) were compared using quantitative coronary analyses (QCA). Minimal lumen diameter (1.30 ± 0.38 mm vs. 1.54 ± 0.46 mm, p lt;0.001) and reference vessel diameter (2.88 ± 0.66 mm vs. 2.92 ± 0.64 mm, p=0.001) were increased significantly and PDS (54.49 ± 9.38 vs. 47.5 ± 11.17, p lt;0.001) and percentage area stenosis (78.38 ± 8.65 vs. 71.29 ± 11.84, p= lt;0.001) were decreased significantly. There was no significant change in lesion length (13.52 ± 5.59 mm vs. 13.25 ± 5.31 mm, p= 0.078). 65 (31.4%) of these significant lesions (PDS ≥50% by QCA) were regressed (less than 50%) on follow-up CAG. In multivariable analyses; current smoking, clopidogrel use after the P-PCI and history of coronary artery disease were the independent predictors of decrease in PDS. Conclusion: Significant exaggeration of non-culprit lesion stenosis severity occurs at the time of acute STEMI.

Keywords

• primary percutaneous coronary intervention
• multi-vessel disease
• non-culprit lesion
• quantitative coronary analysis
• primer perkütan koroner girişim
• çoklu damar hastalığı
• sorumlu olmayan lezyon
• kantitatif koroner analiz