Long-term outcome following successful reopening of abrupt closure after coronary angioplasty

Alan N. Tenaglia, Donald F. Fortin, David J. Frid, Laura H. Gardner, Charlotte L. Nelson, James E. Tcheng, Richard S. Stack, Robert M. Califf

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22 Scopus citations

Abstract

Abrupt closure after coronary angioplasty is often successfully treated by repeat dilation. Long-term follow-up, including 6-month repeat catheterization and 12-month clinical evaluation, was obtained in 1,056 patients treated with acute (n = 335) or elective (n = 721) coronary angioplasty to evaluate the long-term impact of successful reopening of abrupt closure. Abrupt closure occurred in 13.5% of patients and was successfully reopened in 58%. Adverse outcomes including restenosis, death, bypass surgery, myocardial infarction and repeat angioplasty were compared between patients with successfully treated abrupt closure and those with successful procedures (residual diameter stenosis ≤ 50%) without abrupt closure. For patients with acute angioplasty, the restenosis rates (>50% diameter stenosis at follow-up) were 64% for those with successfully treated abrupt closure versus 36% for those with successful procedures without abrupt closure (p < 0.01). In addition, subsequent myocardial infarction (12 vs 3%; p = 0.01) and repeat angioplasty (21 vs 10%; p = 0.03) were more frequent in the group with abrupt closure. For patients with elective angioplasty, restenosis was 43% in those with successfully treated abrupt closure versus 45% in those without abrupt closure (p = NS). Subsequent death and myocardial infarction were more frequent in patients with abrupt closure (death: 12 vs 3% [p < 0.01]; myocardial infarction: 13 vs 3% [p < 0.01]). Long-term adverse events are increased in patients with successfully treated abrupt closure compared to those with successful procedures without abrupt closure.

Original languageEnglish (US)
Pages (from-to)21-25
Number of pages5
JournalThe American Journal of Cardiology
Volume72
Issue number1
DOIs
StatePublished - Jul 1 1993

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Tenaglia, A. N., Fortin, D. F., Frid, D. J., Gardner, L. H., Nelson, C. L., Tcheng, J. E., Stack, R. S., & Califf, R. M. (1993). Long-term outcome following successful reopening of abrupt closure after coronary angioplasty. The American Journal of Cardiology, 72(1), 21-25. https://doi.org/10.1016/0002-9149(93)90212-U