J Cardiovasc Interv.  2023 Jan;2(1):31-40. 10.54912/jci.2022.0017.

Impact of Intermediate Lesions on the 10-Years Clinical Outcomes in Patients With Significant Coronary Artery Disease

• Kim YK
• Yang DJ
• Jang CW
• Kwon SH
• Lee JK
• Park SS
• Seo YH
• Kim KH
• Kwon TG
• Lee MS
• Bae JH

• KMID: 2561262
• DOI: http://doi.org/10.54912/jci.2022.0017

Abstract

Background
Intermediate coronary lesions (ILs) are challenging to treat. This study aimed to assess the impact of ILs on long-term clinical outcomes in patients with significant coronary lesions (SLs).
Methods
This was a non-randomized, retrospective, single-center study. The study subjects were patients with SL (total: n = 403, men: n = 249), followed up for 10 years (118.5 ± 5.5 months), and divided into 2 groups according to the presence of IL (IL − and IL + groups with 192 and 211 patients, respectively). The primary outcome was the occurrence of major adverse cardiovascular events (MACE), which included all-cause death, myocardial infarction (MI), stroke, and revascularization (RVSC).
Results
There were no significant differences in MACEs between the IL − and IL + groups (death, 7.8% vs. 12.3%; MI, 0.0% vs. 2.4%; stroke, 5.7% vs. 6.6%; and RVSC, 19.8% vs. 24.6%). However, the RVSC rate related to IL was lower (5.2% vs. 13.2%) than that related to stented lesions in all subjects. The important predictors for total MACEs in all subjects were the number of ILs and ejection fraction. The predictors of total RVSC events were IL location (right coronary artery [RCA]) and hypertension. The predictor of IL-related RVSC was the number of ILs.
Conclusion
Ten-year clinical outcomes of IL were excellent and better than those of stented lesions in patients with SL. Thus, ILs can be managed with optimal medical treatment with acceptable outcomes in those patients. Multiple ILs and RCA ILs are associated with an increased risk of MACE. Therefore, these features of IL should be carefully managed.

Keyword

Coronary artery disease; Coronary artery stenosis; Prognosis