Non-culprit Coronary Lesions in Young Patients Have Higher Rates of Atherosclerotic Progression

The present study aimed to investigate whether non-culprit coronary lesions (NCCLs) in young patients (<45 years) who underwent percutaneous coronary intervention (PCI) with stents have higher rates of atherosclerotic progression than older patients. Eight hundred and forty-eight consecutive patients who underwent successful PCI with stents and second coronary angiography in a single center from January 7, 2008 to May 7, 2013 were enrolled. NCCL progression was assessed using three-dimensional quantitative coronary angiography and was defined as ≥ 10% diameter reduction of preexisting stenoses of ≥ 50%, ≥ 30% diameter reduction of <50% stenoses, development of a new stenosis of ≥ 30% in a previously normal segment, or progression to total occlusion. The mean time interval between two catheterization was 10.79 months; 136 (16.0%) patients exhibited progression of NCCLs. Multivariate Cox regression analysis (stepwise) showed young age to be an independent determinant of NCCL progression. Compared with the older patients(≥ 45 years), the crude hazard ratio (HR) for NCCL progression in the young patients(<45 years) was 2.17 (95% CI 1.42-3.30; P < 0.001); the association remained significant after adjustment for sex, ST elevation myocardial infarction, body mass index, systolic and diastolic blood pressure, serum lipids, fasting blood glucose, smoking, drinking, hypertension, family history of coronary heart disease, diabetes mellitus, medication use and NCCL characteristics (adjusted HR 1.70, 95% CI 1.06-2.72; P = 0.029). NCCLs in young patients (<45 years) with coronary artery disease have high rates of atherosclerotic progression.