Clinical characteristics, risk factors, and prognostic analyses of coronary small vessel disease: a retrospective cohort study of 986 patients

ABSTRACT

Background and aims

Coronary small vessel disease (CSVD) is often associated with significant percutaneous coronary intervention (PCI) related complications, complex lesions, complex PCI, and poor long-term prognosis. We designed this retrospective study to clarify the characteristics, risk factors, and prognostic analyses of CSVD in Chinese populations

Methods

A total of 986 patients who underwent coronary angiography and stent implantation at the First Affiliated Hospital of Zhejiang University School of Medicine were evaluated. Patients were grouped into CSVD or non-small vessel disease (non-CSVD) according to stent diameter. Clinical data, coronary angiography, and long-term follow-up were recorded. Multivariate logistic regression, the Kaplan–Meier method, Log-rank Test, and Cox regression model were used for statistical analysis.

Results

Alcohol consumption (OR = 0.420, 95% CI: 0.299–0.588, P < 0.001) was implicated as a negative CSVD correlation factor. CSVD was more likely to be associated with multi-vessel lesions (79.2% vs. 49.4%, P < 0.001), bifurcation lesions (24.0% vs. 12.4%, P < 0.001), chronic total obstruction lesions (29.5% vs. 9.4%, P < 0.001), and long lesions (55.2% vs. 35.7%, P < 0.001), which reduced the efficacy of revascularization (70.1% vs. 85.1%, P < 0.001). In the follow-ups, cardiac death (2.3% vs. 0.4%, P = 0.008), stroke (1.9% vs. 0.3%, P = 0.007), target lesion revascularization (5.8% vs. 2.9%, P = 0.029), target vessel revascularization (6.8% vs. 3.4%, P = 0.016), and non-target vessel revascularization (7.8% vs. 4.0%, P = 0.012) were all substantially higher in CSVD patients. Troponin I level (OR = 1.008, 95% CI: 1.004–1.012, P < 0.001), complete revascularization (OR = 0.292, 95% CI: 0.160–0.531, P < 0.001), and aspirin administration (OR = 0.041, 95% CI: 0.013–0.131, P < 0.001) were independent predictors of MACE events of all patients.

Conclusion

Compared to non-CSVD, CSVD was associated with more complex lesions, had worse revascularization efficacy, and a poorer prognosis.

KEYWORDS:

• Coronary small vessel disease
• Clinical characteristics
• Risk factors
• Interventional therapy
• Prognostic analysis

Acknowledgments

The authors greatly acknowledge Professor Yi Shen from the Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, for significant help, suggestions, and guidance of statistics during the whole study.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics statement

This study was approved by the ethical committee at the First Affiliated Hospital of Zhejiang University School of Medicine with ID: IIT20210284A.

Data availability statement

Data will be available upon reasonable request ([email protected]).

Author contributions

Qiwen Wang designed the research; Liujun Jiang and Xiaolei Xu acquired data; Yue Chen and Xiao Cui analyzed and explained data; Yue Chen drafted the manuscript; Yue Chen, Xiao Cui, Qiwen Wang, and Chaoyang Huang revised the manuscript. All authors have reviewed the manuscript and approved the final manuscript as submitted.

SUPPLEMENTARY MATERIAL

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2023.2221110

Additional information

Funding

This paper was funded by the National Natural Science Foundation of China (82270531) and Zhejiang Provincial Natural Science Foundation of China (LY22H020003).