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Multiple coronary angioplasty: A model to discriminate systemic and procedural factors related to restenosis

1988; Elsevier BV; Volume: 12; Issue: 2 Linguagem: Inglês

10.1016/0735-1097(88)90399-3

1558-3597

M. Lambert, Raoul Bonan, Gilles Côté, Jacques Crépeau, Pierre de Guise, Jacques Lespérance, Paul-Robert David, David D. Waters,

Acute Myocardial Infarction Research

To assess the interrelation of clinical and procedural factors responsible for resteosis, 119 patients undergoing coronary arteriography were studied a mean of 5.8 ± 3 montas after successful multiple percutaneous transluminal coronary angioplasty. In all clinical, angiographic and procedural variables, the 119 patients undergoing repeat catheterization were similar to the 87 patients that did not. Overall, restenosis occurred in 74 (34%) of 215 lesions. Sixty-three patients bad no restenosis, 44 had at least one restenosis and 12 bad restenosis at all angioplasty sites. The statistical distribution of restenoses did not follow a binomial model, suggesting that restenosis is more than a lesion-specific phenomenon. Of all the clinical and procedural variables assessed by multivariate logistic regression analysis, only percent stenosis before angioplasty (p < 0.01), diabetes mellitus (p < 0.01) and percent stenosis after angioplasty (p < 0.05) were predictive of restenosis in the entire group. Patients with no restenosis and patients with restenosis at all sites were not different with respect to procedural variables; however, patients with restenosis at all sites more often (p < 0.05) had diabetes and recent onset angina. In contrast, patients with no restenosis differed from patients with isolated restenosis with respect to procedurai variables: severity of stenosis before and after angioplasty, balloon/artery lumen ratio and maximal inflation pressure. Thus, procedural factors may be more related to isolated restenosis, but patient-related factors such as diabetes and recent onset angina may play a more important role in patienta with multiple restenoses.