Study on Risk Factors and Prognostic Value of Non-target Lesion Progression in Patients With Coronary Artery Disease

Condition(s) studied

Investigational drug(s) / intervention(s)

Progression of non-target vessels: Drug-eluting stents (DES) have markedly reduced the risks of target lesion restenosis and repeat revascularization \[2\]. Nevertheless, the progression of coronary atherosclerosis does not cease after percutaneous coronary intervention (PCI). Clinical evidence demonstrates that even after successful target lesion revascularization and adherence to standardized secondary prevention therapy, patients may still develop progression of non-target lesions (NTLs) during follow-up, which further leads to non-target vessel revascularization, recurrent myocardial infarction, and major adverse cardiovascular events (MACE) \[3\]. This finding indicates that post-PCI risk is not solely driven by severely stenotic target lesions; to a certain extent, it may also arise from initially untreated non-target lesions that harbor progression potential. This issue has become one of the key factors limiting the long-term clinical benefit of patients with coronary artery disease following interventional therapy.

Study summary

The goal of this observational study is to explore the risk factors and prognostic value of non-target coronary lesion progression in patients aged 18-80 years with established coronary artery disease who are scheduled for repeat coronary angiography. The main questions it aims to answer are:

What clinical, inflammatory and metabolic factors are independently associated with the progression of untreated non-target lesions after percutaneous coronary intervention? Does the initial interventional strategy (drug-eluting stent vs. drug-coated balloon) influence the long-term progression of non-target coronary lesions and subsequent clinical outcomes? Researchers will compare participants treated with drug-eluting stents (DES) and those treated with drug-coated balloons (DCB) at their prior index procedure to see if different local interventional modalities lead to differences in non-target lesion progression and major adverse cardiovascular events during follow-up.

Participants will:

Undergo clinically indicated repeat coronary angiography, with offline quantitative coronary angiography (QCA) analysis of all coronary segments Provide baseline clinical data, medical history and blood samples for inflammatory and metabolic biomarker testing Complete 3 years of regular clinical follow-up to track lesion evolution and cardiovascular endpoints

Eligibility

Primary outcome measure(s)

• Angiographic Progression of Non-Target Lesions — From baseline interventional procedure to follow-up coronary angiography (median follow-up duration of approximately 12 to 24 months, subject to the timing of routine clinical follow-up angiography); lesion progression-related events will be continuously
  Quantitative coronary angiography (QCA) will be performed to compare coronary angiographic images obtained at baseline (during the initial percutaneous coronary intervention) and during follow-up. All non-target coronary segments that did not receive initial interventional treatment will be quantitatively measured for luminal diameter stenosis to assess the progression of atherosclerotic lesions. Non-target lesion progression is defined as meeting any of the following criteria: an absolute increase of ≥20% in luminal diameter stenosis in the same non-target segment at follow-up angiography compared with baseline; progression from baseline diameter stenosis \<50% to clinically significant stenosis with diameter stenosis ≥50%; or new-onset atherosclerotic lesions with diameter stenosis ≥50% in non-target segments during follow-up. Based on this endpoint, clinical, inflammatory and metabolic risk factors associated with non-target lesion progression will be analyzed, and the incidence of

Trial sites (1)

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