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ǥ : ȣ - 530967   71 
Large-scale review in terms with the predictors of target lesion revascularization, target vessel revascularization and revascularization of non target vessel progression
가톨릭의대 순환기 내과¹
고윤석¹, 승기배¹ , 서석민¹ , 추은호¹ , 박만원¹ , 윤성규¹ , 김지희¹ , 엄재선¹ , 박훈준¹ , 김범준¹ , 정해억¹ , 장기육¹ , 오용석¹ , 백상홍¹ , 정욱성¹ , 김재형¹
Backgrounds: In drug eluting stent (DES) era, the predictors of target lesion revascularization (TLR) and target vessel revascularization (TVR) have been presented in many articles. But, there is no settled predictor of TLR/TVR. So we investigated which factors have an effect on TLR/TVR in addition, which factors are associated with percutaneous coronary intervention (PCI) of non target vessel lesion progression. Methods: We reviewed consecutive 2223 patients and 3012 lesions successfully performed PCI using DES and focused on revascularization such as target lesion, target vessel and non target lesion progression from 2003 to 2008 in Seoul St. Mary’s Hospital. Results: Patients underwent PCI by sirolimus-eluting stent, paclitaxel-eluting stent, zotarolimus-eluting stent, everolimus-eluting stent and their combination (60%, 27.2%, 4.6%, 6.9%, 1.3%, respectively). And among kinds of stent, there were no difference in clinical and angiographic characteristics. The incidence of TLR, TVR and non target vessel revascularization was 5.9%, 2.7% and 3.2%. According to cox hazard regression analysis, the predictors of TLR were stent diameter, bifurcation lesion and overlapping by other kinds of stents (table 1). In contrast, the predictor of TVR was current smoking (Hazard ratio (HR) 2.413, 95% confidence interval (CI) 1.019-5.716, P=0.045). And the predictors of non target vessel revascularization were male gender (HR 3.168, 95% CI 1.509-6.651, P=0.001) and total cholesterol level (HR 1.009, 95% CI 1.003-1.015, P=0.005). Conclusions: The risk of TLR is associated with procedural process such as stent diameter, bifurcation lesion and overlapping by other kind of stents, but the risk of TVR and non target vessel revascularization is associated with patients clinical characteristics such as smoking, gender and lipid profile.

Table 1. The predictors of TLR by cox hazard regression analysis

 

Variables

Hazard ratio

95% confidence interval

P-value

Stent diameter

0.497

0.289-0.856

0.013

Bifurcation lesion

1.846

1.066-3.196

0.029

Overlapping by other kind of stents

3.114

1.261-7.689

0.014

 



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