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European Heart Journal 1998 19(7):1047-1053; doi:10.1053/euhj.1997.0863
Copyright © 1998 by the European Society of Cardiology.
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Impact of restenosis 10 years after coronary angioplasty

C Espinola-Kleinaf1, RupprechtH.-J a, R Erbelb, B Nafea, R Brenneckea and J Meyera

a Second Medical Clinic, Institute for Statistics and Informatics, Johannes Gutenberg University, Mainz
b Department of Cardiology, University Clinic, Essen, Germany

accepted November 21, 1997

Aims

The aim of the study was to compare the 10-year follow-up results of patients with or without restenosis following single-vessel percutaneous transluminal coronary angioplasty (PTCA).

Methods and Results

A total of 313 patients with successful PTCA (≥20% reduction in luminal diameter narrowingwithout acute complications) and a control angiography 6 months after PTCA were included in the study. Events during the follow-up period were defined as death, myocardial infarction, bypass surgery, or repeat PTCA. Statistical evaluation was performed by the Fisher test, logistic regression, and life-table analysis. Restenosis (loss of >50% of the initial gain and diameter stenosis of <50%) was found in 87 (28%) patients. During follow-up, 11 patients (5%) without restenosis (group A) and 11 (13%) patients with restenosis (group B) died (P<0·05). In group A, 17 (8%) patients and in group B, 11 (13%) patients suffered myocardial infarction (ns); 17 group A (8%) patients and 25 (29%) group B patients had bypass surgery (P<0·0001), and 34 (15%) group A patients and 55 (63%) group B patients underwent repeat PTCA (P<0·0001). Logistic regression analysis identified restenosis as an independent risk factor that increases the risk of death 2·8-fold (P=0·02), bypass surgery 5·6-fold (P<0·0001), and repeat PTCA 10-fold (P<0·0001).

Conclusion:

We conclude that patients with restenosis had a poorer long-term outcome than patients without restenosis. Although most patients with restenosis underwent repeat PTCA, the survival rate without any serious adverse events was only 59%, compared with 83% in patients without restenosis (P<0·0001).

Key Words: Coronary angioplasty • restenosis • long-term outcome

f1 Correspondence: Christine Espinola-Klein, Second Medical Clinic, Johannes Gutenberg University, Langenbeckstrasse 1, D-55131 Mainz, Germany.


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