Clinical Study

The Predictors of Target Lesion Revascularization and Rate of In-Stent Restenosis in the Second-Generation Drug-Eluting Stent Era

Table 1

Baseline patients and lesion characteristics according to early TLR.

Clinical FactorsEarly TLR(-)Early TLR(+)P
(354 patients)(40 patients)

Age (years old)65.3±10.466.9±11.00.369
BMI (kg/m2)24.8±2.923.9±3.30.073
Male sex, n (%)265 (74.9)24 (60.0)0.068
Previous PCI, n (%)38 (10.7)10 (25.0)0.018
Diabetes mellitus, n (%)114 (32.2)19 (47.5)0.078
Hypertension, n (%)246 (69.5)29 (72.5)0.833
CRF, n (%)137 (38.7)25 (62.5)0.006
Dyslipidemia, n (%)225 (63.6)23 (57.5)0.562
Current smoking, n (%)95 (26.8)9 (22.5)0.689
FHx of CAD, n (%)44 (12.4)6 (15.0)0.807
LV ejection fraction (%)60.3±8.357.3 ± 10.60.119
Clinical diagnosis0.127
 (i) Silent ischemia, n (%)21 (5.9)0 (0)
 (ii) Stable angina, n (%)209 (59.0)23 (57.5)
 (iii) Unstable angina, n (%)71 (20.1)7 (17.5)
 (iv) STEMI, n (%)22 (6.2)2 (5.0)
 (v) NSTEMI, n (%)31 (8.8)8 (20.0)
Multi Vessel disease, n (%)255 (72.0)31 (77.5)0.576

Laboratory tests

WBC (109/L)6.9±2.46.5±1.70.332
Hemoglobin (g/dl)13.6±1.812.9±2.00.018
Creatinine(mg/dl)1.05±0.441.39±1.600.183
GFR(ml/min/1.73m2)70.8±24.057.5±28.20.015
Total cholesterol (mg/dl)157±38159±450.845
Triglyceride (mg/dl)140±86120±660.193
LDL (mg/dl)97±3594±440.666
HDL (mg/dl)42±1144±120.302
CRP (mg/dl)0.40±1.170.37±0.840.870

Medication at discharge

 (i) Aspirin, n (%)353 (99.7)40 (100.0)1.000
 (ii) Clopidogrel, n (%)353 (99.7)40 (100.0)1.000
 (iii) DAPT, n (%)#352 (99.4)40 (100.0)1.000
 (iv) Beta blocker, n (%)251 (70.9)28 (70.0)1.000
 (v) Statin, n (%)337 (95.2)39 (97.5)1.000
 (vi) CCB, n (%)75 (21.2)11 (27.5)0.418
 (vii) ACEI, n (%)85 (24.0)16 (40.0)0.035
 (viii) ARB, n (%)134 (37.9)19 (47.5)0.237

Medication at first follow-up

 (i) Aspirin, n (%)351 (99.2)40 (100.0)1.000
 (ii) Clopidogrel, n (%)346 (97.7)39 (97.5)1.000
 (iii) DAPT, n (%)#343 (96.9)39 (97.5)1.000
 (iv) Beta blocker, n (%)266 (75.1)28 (70.0)0.451
 (v) Statin, n (%)352 (99.4)40 (100.0)1.000
 (vi) CCB, n (%)79 (22.3)8 (20.0)0.842
 (vii) ACEI, n (%)36 (10.2)8 (20.0)0.106
 (viii) ARB, n (%)145 (41.0)13 (32.5)0.395

Medication at second follow-up

 (i) Aspirin, n (%)324 (91.5)38 (95.0)0.758
 (ii) Clopidogrel, n (%)300 (84.7)37 (92.5)0.239
 (iii) DAPT, n (%)#272 (76.8)35 (87.5)0.159
 (iv) Beta blocker, n (%)256 (72.3)25 (62.5)0.200
 (v) Statin, n (%)349 (98.6)39 (97.5)0.476
 (vi) CCB, n (%)68 (19.2)9 (22.5)0.674
 (vii) ACEI, n (%)28 (7.9)7 (17.5)0.070
 (viii) ARB, n (%)137 (38.7)13 (32.5)0.495

Lesion factorsEarly TLR(-)Early TLR(+)
(886 lesions)(58 lesions)

Treated coronary location0.854
 (i) LAD, n (%)411 (46.4)28 (48.3)
 (ii) LCX, n (%)218 (24.6)16 (27.6)
 (iii) RCA, n (%)255 (28.8)14 (24.1)
Bifurcation lesion, n (%)308 (34.8)25 (43.1)0.204
Calcified lesion0.004
 (i) None, n (%)451 (51.2)26 (44.8)
 (ii) Mild, n (%)155 (17.6)4 (6.9)
 (iii) Moderate, n (%)114 (12.9)7 (12.1)
 (iv) Severe, n (%)161 (18.3)21 (36.2)
Tortuous lesion0.465
 (i) None, n (%)819 (92.9)56 (96.6)
 (ii) Mild, n (%)24 (2.7)0 (0)
 (iii) Moderate, n (%)26 (2.9)2 (3.4)
 (iv) Severe, n (%)13 (1.5)0 (0)
Angulation lesion, n (%)0.305
 (i) None (<45°), n (%)821 (93.3)56 (98.2)
 (ii) Moderate (45°<90°), n (%)37 (4.2)1 (1.8)
 (iii) Extreme n (>90°), n (%)22 (2.5)0 (0)
Thrombus in lesion, n (%)29 (3.3)0 (0)0.291
Ostial lesion, n (%)169 (19.1)14 (24.1)0.390
Ulceration, n (%)2 (0.2)3 (5.2)0.002
Aneurysm, n (%)10 (1.1)0 (0)1.000
Lesion type0.142
 (i) A, n (%)92 (10.4)8 (13.8)
 (ii) B1, n (%)214 (24.2)8 (13.8)
 (iii) B2, n (%)52 (5.9)7 (12.1)
 (iv) C, n (%)499 (56.3)34 (58.6)
Type B2/C lesion, n (%)551 (64.3)41 (71.9)0.305
Reference vessel diameter (mm)2.92±0.512.78±0.660.100
Lesion length (mm)27.7±17.128.8±19.40.647
Pre-procedure MLD (mm)0.74±0.500.68±0.490.385
Pre-procedure DS (%)74.7±15.775.9±15.50.569
Post-procedure MLD, in- stent (mm)2.49±0.432.26±0.48<0.001
Post-procedure MLD, in-segment (mm)2.13±0.511.85±0.57<0.001
Post-procedure DS, in- stent (mm)11.4±8.118.0±11.2<0.001
Post-procedure DS, in-segment (mm)21.0±11.329.9±13.6<0.001

TLR, target lesion revascularization; BMI, body mass index; kg, kilogram; PCI, percutaneous coronary intervention; CRF, chronic renal failure; FHx, family history; CAD, coronary artery disease; LV, left ventricle; STEMI, ST-elevation myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction; WBC, white blood cell; GFR, glomerular filtration rate; LDL, low density lipoprotein cholesterol; HDL, high density lipoprotein cholesterol; CRP, C-reactive protein; DAPT, dual antiplatelet therapy; CCB, calcium channel blockers; ACEI, angiotensin converting enzyme inhibitors; ARB, angiotensin II receptor blockers; LAD, left anterior descending; LCX, left circumflex; RCA, right coronary artery; MLD, minimal lumen diameter; DS, diameter stenosis.
# DAPT: combination of aspirin and clopidogrel.