Predictors of restenosis after implantation of 2.5 mm stents in small coronary arteries.
BACKGROUND
The results of stent implantation for small coronary disease have been inconclusive. The purpose of the present study was to evaluate the factors in predicting the risk of angiographic restenosis after 2.5-mm stent implantation for small coronary arteries.


RESULTS
The study group comprised 134 consecutive patients who had a reference small coronary artery with diameter from 1.8 mm to 2.5 mm on quantitative coronary angiography and who had been successfully treated by stent implantation with a 2.5-mm stent. Of the 134 patients, 55 had angiographic restenosis (41%). The rate of target lesion revascularization was 32%. Diabetes mellitus, acute coronary syndrome, lesion length, bifurcation lesion, lower left ventricular ejection fraction (LVEF), stent strut, stent/artery ratio, and stent length were identified as predictors of restenosis by univariate analysis. Subsequent multivariate analysis revealed that lower LVEF (odds ratio (OR) 3.37, p=0.01), bifurcation lesion (OR 2.47, p=0.04), thicker stent strut (OR 2.30, p=0.04), and longer stent length (OR 1.05, p=0.02) were significant predictors of restenosis.


CONCLUSIONS
Two pre-interventional factors (reduced left ventricular function and bifurcated lesion) and 2 procedure-related factors (thickness of stent strut and total stent length) were identified as predictors of restenosis. These factors should be taken into account when deciding on the percutaneous coronary intervention strategy for small coronary artery disease.
The Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. Raisuke329@aol.com
Iijima
I
Raisuke
Ikari
I
Yuji
Miyazawa
M
Akiyoshi
Nakajima
N
Hiroyoshi
Hara
H
Kazuhiro
D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome