title: Change of the complexity of coronary artery disease after percutaneous coronary intervention with drug-eluting stent.
abstract: We investigated changes of the complexity of coronary artery disease (CAD) after drug-eluting stent (DES) implantation using SYNTAX score and the predictor of worsened SYNTAX score at follow-up. 116 consecutive patients who underwent de novo PCI with first-generation DES were enrolled. SYNTAX scores were obtained from coronary angiography before PCI, just after final PCI and at follow-up after 6-8 months and investigated. SYNTAX score changed from 19.8 ± 11.9 before PCI to 13.7 ± 10.6 after PCI and to 15.0 ± 11.7 at follow-up. SYNTAX score before PCI was significantly correlated with a difference of SYNTAX score between before and after PCI [acute improved score (AIS)] and between after PCI and at follow-up (r = 0.5, p < 0.0001, r = 0.3, p = 0.002, respectively). At follow-up, SYNTAX score improved from just after PCI in 6.0% of the subjects, did not change in 60.3% and worsened in 33.6%. In-stent restenosis occurred in 43.8% of the patients with worsened score, and progression of lesion occurred in 62.5%. On multivariate analysis for worsened score, only diabetes was a significant independent predictor (OR 3.0, 95%CI 1.3-7.2, p = 0.01); however, SYNTAX scores both before PCI and AIS were not predictors. With regard to re-exacerbation of the complexity of CAD after PCI with DES, we need to exhibit caution in diabetic patients and there is no need to consider the complexity of CAD before PCI or the degree of acute improvement of complexity of CAD with PCI.
authors.affiliation: Division of Cardiology, Japan Community Health care Organization, Kobe Central Hospital, 2-1-1 Souyamacho, Kita-ku, Kobe, Hyogo, 651-1145, Japan, tytanaka@hera.eonet.ne.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kayoko
authors.initials: K
authors.lastname: Mera
authors.forename: Takanori
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Junpei
authors.initials: J
authors.lastname: Todoroki
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Morihiko
authors.initials: M
authors.lastname: Kondo
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Otomo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome