[Clinical prognosis of moderate restenosis after percutaneous transluminal coronary angioplasty].
Follow-up angiography after percutaneous transluminal coronary angioplasty (PTCA) often demonstrates "moderate" angiographic restenosis, but the need for subsequent revascularization is difficult to determine. We examined the clinical outcome of patients with moderate angiographic restenosis after PTCA. Follow-up angiography performed in 96 patients within 4 months showed light restenosis (LR:stenosis < 40%) in 52 patients, moderate restenosis (MR:40-70%) in 21, and severe restenosis (SR: > 70%) in 23. One of 21 patients with MR underwent repeat PTCA after a positive exercise test. The remaining 20 patients with MR were compared with 52 with LR (follow-up: 12-18 months). Five patients with MR underwent repeat PTCA for recurrence of angina in the follow-up period. Log rank analysis of the Kaplan-Meier estimates for event-free survival (death, myocardial infarction CABG, re-PTCA) showed the outcome was significantly worse for MR patients. However, 14 MR patients who had no cardiac event demonstrated regression of stenosis at 1-year follow-up angiography (58.2% to 45.4%). Moderate restenosis at angiographic follow-up was observed in 30% of all PTCA patients. Moderate restenosis patients have a worse prognosis than light restenosis patients. Adequate follow-up management is mandatory for moderate restenosis patients.
Fukuzawa
S
S
Division of Cardiology, Funabashi Municipal Medical Center.
Ozawa
S
S
Katagiri
M
M
Watanabe
H
H
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012044:Regression Analysis