Patients with a hemoglobin A1c of 6.5% or higher and triglyceride levels of 5.6 mmol/L or higher, as well as Synergy Between PCI with Taxus and Cardiac Surgery scores of 23 or higher, face increased risks for native coronary atherosclerosis progression post-percutaneous coronary intervention.
A retrospective cohort study, published in Cardiovascular Innovations and Applications, included 462 patients who underwent percutaneous coronary intervention (PCI) between January 2017 and December 2019. Patients were divided into progressive (n = 73), and non-progressive (n = 389) groups based on follow-up coronary angiography results. The primary objective was to compare clinical data and identify key risk factors through multivariate Cox regression analysis.
The prevalence of acute coronary syndrome (ACS) was higher in the progressive group. Conversely, high-density lipoprotein cholesterol levels were lower in these patients.
Multivariate analysis identified ACS, elevated HbA1c and triglycerides (TG) levels, and high Synergy Between PCI with Taxus and Cardiac Surgery (SYNTAX) scores as independent risk factors for the progression of native coronary atherosclerosis post-PCI. Elevated HbA1c and TG levels were strongly associated with atherosclerosis progression.
"The development and progression of atherosclerotic lesions are influenced by various risk factors, including systemic arterial hypertension, diabetes mellitus, tobacco use, dyslipidemia, and adiposity. Collectively, these factors increase the likelihood of development of ischemic heart disease," noted investigators. "Most patients undergoing PCI modify their lifestyle habits, such as through adherence to a low-sodium and low-fat diet, smoking cessation, weight management, and regular physical activity. Despite these changes, they continue to use antihypertensive and antidiabetic medications."
The investigators reported no potential conflicts of interest.