Repeat percutaneous coronary angioplasty; clinical and angiographic follow-up in patients with stable or unstable angina pectoris.
This study analyses the immediate outcome and the risk of recurrent restenosis in patients who, at the time of repeat coronary angioplasty for a first restenosis, had unstable (n = 50), 19%) or stable (n = 218, 81%) angina. Successful angioplasty was accomplished in 250 (93%) patients, 222 (89%) of whom had follow-up angiography. Mean time from initial to repeat angioplasty was shorter (P = 0.0002) and angiographic evidence of thrombus was commoner (P = 0.0001) in the unstable group. Major complications (coronary artery bypass grafting or myocardial infarction) were more frequent (P < 0.01) in the unstable group (6% vs 0.5%); no procedure-related deaths occurred. The angiographic rate of restenosis was significantly higher in the unstable group (61% vs 43%, P < 0.05). Despite this high rate of recurrent restenosis, most of the patients in both groups were either asymptomatic or had atypical chest pain at follow-up. Repeat coronary angioplasty, in patients with unstable angina, has a high primary success rate but a higher risk of acute complications than in patients with stable angina. The angiographic rate of restenosis was significantly higher in unstable than in stable patients; however, the clinical status of most patients was improved at follow-up.
Bauters
C
C
Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, Lille, France.
Lablanche
J M
JM
McFadden
E P
EP
Leroy
F
F
Bertrand
M E
ME
D000368:Aged; D000787:Angina Pectoris / Q000628:therapy*; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome