title: Contributors to newly developed coronary artery disease in patients with a previous history of percutaneous coronary intervention beyond the early phase of restenosis.
abstract: OBJECTIVE
  The low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio is considered to be a sensitive marker of the risk of atherosclerotic cardiovascular disease; however, in patients with a previous history of percutaneous coronary intervention (PCI), there is little information regarding the predictive value of this parameter beyond the period of early restenosis. The aim of this study was to investigate contributing factors to newly developed coronary artery disease in patients with a previous history of PCI after stabilization.
  
  
  METHODS
  The clinical characteristics of 238 patients with a previous history of PCI who underwent coronary angiography following recurrent cardiac ischemia beyond the period of early restenosis were examined.
  
  
  RESULTS
  Overall, 64% of the patients underwent late revascularization, while 31% and 50% underwent late target lesion revascularization and new lesion revascularization, respectively. A multivariate analysis identified the LDL-C/HDL-C ratio to be an independent contributor to late revascularization (hazard ratio (HR), 1.37; p<0.001). Similarly, the independent contributors to late target lesion revascularization and new lesion revascularization were the non-HDL-C level and LDL-C/HDL-C ratio, respectively. Based on the median value of the LDL-C/HDL-C ratio, the patients were classified into high and low LDL-C/HDL-C ratio groups. The log-rank test revealed a significantly higher incidence of late revascularization in the high-LDL-C/HDL-C ratio group than in the low-LDL-C/HDL-C ratio group among the patients with an LDL-C level of ≥ 100 mg/dL (p=0.011). However, the difference between the two groups was diminished among the patients with an LDL-C level of <100 mg/dL (p=0.047), and only diabetes mellitus (HR, 2.239; p=0.009) was found to be an independent contributor to late coronary revascularization in these patients.
  
  
  CONCLUSIONS
  The LDL-C/HDL-C ratio is an important contributor to the development of new coronary artery disease in patients with a previous history of PCI beyond the period of early restenosis, particularly among patients with an LDL-C level of ≥ 100 mg/dL.
authors.affiliation: Division of Cardiology, Shimane University Faculty of Medicine, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Endo
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kageshima
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Sato
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Suga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nasu
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takahashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002317:Cardiovascular Agents / Q000008:administration & dosage; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D023903:Coronary Restenosis / Q000503:physiopathology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL