The Clinical Prediction Factors of Non Chronic Total Occlusion Lesions Progression in Patients Underwent Percutaneous Coronary Intervention for Chronic Total Occlusion Lesions

Abstract Backgroud :To investigate the clinical prediction factors of non chronic total occlusion lesions progression in patients underwent percutaneous coronary intervention(PCI) for chronic total occlusion lesions.Methods: A total of 450 unstable angina patients (57.1 ± 9.2 years) underwent PCI from January 2016 to December 2018 in Beijing Anzhen Hospital were enrolled in this study. All patients underwent PCI as treatment for chronic total occlusion lesions. Clinical and angiographic follow-up were performed in 12 months. All patients were divided into non chronic total occlusion lesions(NCTOL) progression group (205 cases) and the control group (275 cases) according to angiographic follow-up outcome in 12 months. The clinical and angiographic features were analyzed.Results: levels of adenosine diphosphate (ADP) induced platelet aggregation rate(ADP-IPA) (51.89 ± 14.81 vs 39.63 ± 17.12，P <0.01), lipoprotein(a)(Lp(a))(0.22 ± 0.26 vs 0.14 ± 0.18,P < 0.05) in NCTOL progression group were significantly higher than those in the control group. Logistic regression showed that ADP induced PAR (odds ratio =1.047, 95% confidence interval:1.014-1.082, P = 0.005), Lp(a) (odds ratio =11.972, 95% confidence interval: 1.230 -116.570, P = 0.033) were independent predictors of NCTOL progression. Partial correlation analysis showed that ADP-IPA was positively correlated with NCTOL progression( r = 0. 351,P < 0. 001) .Receiver operating characteristic(ROC) curve showed that the boundary point of ADP-IPA to predict NCTOL progression was 30%, the sensitivity was 86.2% and the specificity was 68.9%.Conclusions: ADP-IPA may be an valuable predictor for NCTOL progression .in unstable angina patients underwent percutaneous coronary intervention(PCI) for chronic total occlusion lesions.