| Summary: | Aim: Non-culprit lesion severity has often been exaggerated at the time of acute ST segment elevation myocardial infarction (STEMI). We aimed to determine changes in non-culprit lesions severity on follow-up coronary angiography (CAG) and independent predictors of these changes.
Material and Methods: We retrospectively evaluated the changes in non-culprit lesion stenosis on follow-up CAG which was done within 2 months after primary percutaneous coronary intervention (P-PCI) in patients presenting with STEMI.
Results: 154 patients were included in this study and 207 non-culprit lesions (percentage diameter stenosis (PDS) ≥50%) were compared using quantitative coronary analyses (QCA). Minimal lumen diameter (1.30 ± 0.38 mm vs. 1.54 ± 0.46 mm, p lt;0.001) and reference vessel diameter (2.88 ± 0.66 mm vs. 2.92 ± 0.64 mm, p=0.001) were increased significantly and PDS (54.49 ± 9.38 vs. 47.5 ± 11.17, p lt;0.001) and percentage area stenosis (78.38 ± 8.65 vs. 71.29 ± 11.84, p= lt;0.001) were decreased significantly. There was no significant change in lesion length (13.52 ± 5.59 mm vs. 13.25 ± 5.31 mm, p= 0.078). 65 (31.4%) of these significant lesions (PDS ≥50% by QCA) were regressed (less than 50%) on follow-up CAG. In multivariable analyses; current smoking, clopidogrel use after the P-PCI and history of coronary artery disease were the independent predictors of decrease in PDS.
Conclusion: Significant exaggeration of non-culprit lesion stenosis severity occurs at the time of acute STEMI.
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