Predictors for restenosis after angioplasty of chronic coronary occlusions.
BACKGROUND
The Stenting In Chronic Coronary Occlusion (SICCO) study assessed the effects of additional intracoronary stenting (Palmaz-Schatz) after successful percutaneous transluminal coronary angioplasty (PTCA) of chronic coronary occlusions and showed a significant reduction of restenosis in stented patients.


METHODS
Univariate and logistic regression analyses were used to assess clinical, angiographic and procedure related predictors for restenosis (>50% diameter stenosis at follow-up) and Major Adverse Clinical Events (MACE=cardiac death, lesion-related acute myocardial infarction, repeat lesion-related angioplasty, bypass surgery involving the treated segment or angiographic documentation of reocclusion in non-revascularized patients) in the 114 SICCO patients with an angiographic end-point and 300 days clinical follow-up.


RESULTS
By 6 months the restenosis rate was 53%, and after 300 days MACE had occurred in 39%. Both the rates of restenosis and MACE was significantly reduced by stenting. The restenosis rate was improved by stenting also in patients with a 'stentlike' result after the initial PTCA. In the multivariate model the risk of restenosis was increased by a history of unstable angina, a long lesion and a non-tapering occlusion stump. LAD location was associated with a threefold increased risk of MACE.


CONCLUSIONS
Stent implantation should always be considered in successfully opened chronic occlusions.
Sirnes
P A
PA
Feiring Heart Clinic, Norway. psirnes@online.no
Mølstad
P
P
Myreng
Y
Y
Golf
S
S
D000368:Aged; D000704:Analysis of Variance; D000789:Angina, Unstable / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002908:Chronic Disease; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology; D003643:Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome