TY - JOUR
T1 - Repeat percutaneous transluminal coronary angioplasty and predictors of recurrent restenosis
AU - Quigley, Peter J.
AU - Hlatky, Mark A.
AU - Hinohara, Tomoaki
AU - Rendall, David S.
AU - Perez, Jose A.
AU - Phillips, Harry R.
AU - Califf, Robert M.
AU - Stack, Richard S.
N1 - Funding Information:
From the Interventional Cardiovascular Program, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina. This study was supported in part by grant HL-36587 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland, grant HS-05635 from the National Center for Health Services Research, Hyattsville, Maryland, and grants from the Robert Wood Johnson Foundation, Princeton, New Jersey, and the Andrew Mellon Foundation, New York, New York. Dr. Quigley is a recipient of a Travelling Fellowship Award from the Peel Medical Research Trust, London, England. Manuscript received May 26, 1988; revised manuscript received and accepted November 10, 1988. Address for reprints: Richard S. Stack, MD, Interventional Cardiovascular Program, Box 3 111, Duke University Medical Center, Durham, North Carolina 277 10.
PY - 1989/2/15
Y1 - 1989/2/15
N2 - One hundred seventeen consecutive patients undergoing repeat percutaneous transluminal coronary angioplasty (PTCA) were studied to assess procedural success and recurrent restenosis rates. Clinical, anatomic and procedural variables were examined as predictors of recurrent restenosis using stepwise logistic regression analysis. Primary success was achieved in 114 patients (97.5%). One patient (0.8%) died after acute occlusion. No other in-hospital complications were encountered. After a mean follow-up interval of 218 ± 160 days, 72 of 114 successfully dilated patients (63%) remained angina free. There were no late deaths. Three patients (2.6%) experienced a late myocardial infarction. Follow-up arteriography was performed in 100 patients (88%), of whom 32% had recurrent restenosis (>50% luminal diameter narrowing). On univariate analysis, the presence of 3 clinical variables at repeat PTCA was associated with significantly higher recurrent restenosis rates compared with their absence, that is, unstable angina (48 vs 20%, p = 0.003), diabetes (61 vs 26%, p = 0.003) and hypertension (46 vs 18%, p = 0.003). Patients with recurrent restenosis had a shorter interval between first and second PTCA compared with those who remained patent (136 ± 116 vs 214 ± 163 days, p = 0.018). Multivariate analysis confirmed unstable angina, diabetes and hypertension as independent predictors of recurrent restenosis. Repeat PTCA may be performed for restenosis with a high likelihood of success and low incidence of complications. The rate of recurrent restenosis is similar to that reported for initial angioplasty. Patients with unstable angina, diabetes and hypertension appear to be at higher risk for recurrent restenosis.
AB - One hundred seventeen consecutive patients undergoing repeat percutaneous transluminal coronary angioplasty (PTCA) were studied to assess procedural success and recurrent restenosis rates. Clinical, anatomic and procedural variables were examined as predictors of recurrent restenosis using stepwise logistic regression analysis. Primary success was achieved in 114 patients (97.5%). One patient (0.8%) died after acute occlusion. No other in-hospital complications were encountered. After a mean follow-up interval of 218 ± 160 days, 72 of 114 successfully dilated patients (63%) remained angina free. There were no late deaths. Three patients (2.6%) experienced a late myocardial infarction. Follow-up arteriography was performed in 100 patients (88%), of whom 32% had recurrent restenosis (>50% luminal diameter narrowing). On univariate analysis, the presence of 3 clinical variables at repeat PTCA was associated with significantly higher recurrent restenosis rates compared with their absence, that is, unstable angina (48 vs 20%, p = 0.003), diabetes (61 vs 26%, p = 0.003) and hypertension (46 vs 18%, p = 0.003). Patients with recurrent restenosis had a shorter interval between first and second PTCA compared with those who remained patent (136 ± 116 vs 214 ± 163 days, p = 0.018). Multivariate analysis confirmed unstable angina, diabetes and hypertension as independent predictors of recurrent restenosis. Repeat PTCA may be performed for restenosis with a high likelihood of success and low incidence of complications. The rate of recurrent restenosis is similar to that reported for initial angioplasty. Patients with unstable angina, diabetes and hypertension appear to be at higher risk for recurrent restenosis.
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U2 - 10.1016/0002-9149(89)90309-3
DO - 10.1016/0002-9149(89)90309-3
M3 - Article
C2 - 2521766
AN - SCOPUS:0024552587
VL - 63
SP - 409
EP - 413
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 7
ER -