The Frankfurt experience in restenosis after coronary angioplasty.
Three hundred and thirty-three of 356 patients underwent angiographic follow-up from 1 to 18 months (mean 5.6 months) after percutaneous transluminal coronary angioplasty (PTCA). This is a reangiography rate of 94%. Recurrence rate after the first PTCA was 15% (n = 289). Restenosis rate was defined as an increase from immediate post-PTCA stenosis of more than 30%, or the loss of at least half of the initial gain in luminal diameter. Patients who needed a second angioplasty due to restenosis (n = 30) had a restenosis rate of 33%. Patients with angioplasty in the aortocoronary bypass (n = 14) had a restenosis rate of 45%. All patients were treated before, during and at least 4 to 6 months after the procedure with 60 to 100 mg of isosorbide dinitrate daily plus 160 to 360 mg of verapamil or 100 to 150 mg of gallopamil and 1.5 g of acetylsalicylic acid. In a second retrospective study 111 of 399 patients had the acetylsalicylic acid therapy discontinued or decreased. Forty-two of them developed restenosis (38%), whereas only 49 of 288 patients who continued to receive 1.5 g aspirin developed restenosis (17%). The restenosis rate was 32% in those who received the reduced dose of aspirin. Thus, a large dose of acetylsalicylic acid given before, during and 4 to 6 months after the procedure seems to be necessary to achieve a low rate of restenosis after PTCA.
D000800:Angioplasty, Balloon; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003327:Coronary Disease / Q000517:prevention & control / Q000628:therapy*; D005500:Follow-Up Studies; D005860:Germany, West; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors
D002121:Calcium Channel Blockers; D007548:Isosorbide Dinitrate; D001241:Aspirin