背景：冠状动脉的非靶病变的快速进展对于确定未来心血管事件至关重要。预测非靶病变快速进展的临床因素尚不清楚。本研究的目的是确定冠状动脉的非靶病变快速进展和血运重建的临床预测因素。

方法：连续接受两次冠状动脉造影的冠状动脉粥样硬化性心脏病患者被纳入研究。所有冠状动脉的非靶病变在两次手术中被识别和评估。采用多因素Cox回归分析探讨与冠状动脉的非靶病变快速进展或血运重建相关的临床危险因素。

结果：研究总共纳入1255例患者和1670个病灶。在人群水平中，239名患者(19 %)出现快速进展，186名患者(14.8 %)接受血运重建。在病变水平中，251个病灶(15.0 %)发生快速进展，194个病灶 (11.6 %)采取血运重建。快速进展组的血运重建和心肌梗死发生率明显增高。在多变量分析中， ST段抬高型心肌梗死 ( HR=1.46; 95%CI: 1.03-2.06; p=0.032 )和病变分型(B2/C对A/B1) ( HR=1.76; 95% CI: 1.29-2.40; p =0.001 )与快速进展显著相关。甘油三酯水平( HR=1.10; 95%CI: 1.00-1.20; p=0.040 )和病变分型(B2/C对A/B1)、( HR=1.53; 95% CI: 1.09-2.14;p=0.014 )是病变血运重建的独立预测因素。

结论：STEMI和病变分型作为冠状动脉的非靶病变快速进展的可能预测因素。甘油三酯水平和病变分型作为非靶病变血运重建的可能预测因素。为了预防未来心血管事件的发生，具有这些因素的患者值得进一步注意。

Background: Rapid progression of coronary non-target lesions is essential for the determination of future cardiovascular events. Clinical factors that predict rapid progression of non-target lesions are unclear. The purpose of this study was to identify the clinical predictors of rapid progression and revascularization of coronary non-target lesions.

Methods: Consecutive patients with coronary heart disease who had undergone two serial coronary angiograms were enrolled. All coronary non-target lesions were identified and evaluated at both procedures. Multivariable Cox regression analysis was used to investigate the clinical risk factors associated with rapid progression or revascularization of coronary non-target lesions.

Results: A total of 1255 patients and 1670 lesions were enrolled. In this cohort of patients, 239 (19%) had rapid progression and 186 (14.8%) underwent revascularization. At the lesion level, 251 (15.0%) had rapid progression and 194 (11.6%) underwent revascularization. The incidence of lesion revascularization and myocardial infarction was significantly higher in patients with rapid progression. In multivariable analyses, ST-segment elevation myocardial infarction (HR = 1.46; 95%CI: 1.03-2.06; p =0.032) and lesion classification (B2/C versus A/B1) (HR = 1.76; 95%CI: 1.29-2.40; p = 0.001) were significant factors associated with rapid progression. The level of triglycerides (HR=1.10; 95%CI: 1.00–1.20; p=0.040) and lesion classification (B2/C versus A/B1) (HR=1.53; 95%CI: 1.09–2.14; p=0.014) were predictors of lesion revascularization.

Conclusions: STEMI and lesion classification may be used as predictors of rapid progression of coronary non-target lesions. The level of triglyceride and lesion classification may predict the revascularization of non-target lesions. In order to prevent future cardiovascular events, increased attention should be paid to patients with these factors.