[Previous restenosis as a prognostic indicator in new conventional stent implantation at a different location].
OBJECTIVE
The aim was to determine whether data on restenosis of a previous stent are useful for predicting outcome in patients who need to undergo a second conventional stent implantation at a different location because of coronary disease progression.


METHODS
The study included 80 patients who, during 2000-2004, underwent a second conventional (i.e., not drug-eluting) stent implantation for de novo lesions at a different location to that of the previous stent. Major adverse cardiac events (MACE) were defined as death, non-fatal myocardial infarction, or the need for target lesion revascularization (TLR).


RESULTS
One year after the second procedure, the cumulative incidence of MACE was significantly higher in patients who experienced significant restenosis of the previous stent than in those who did not (40.6% vs 12.5%, P=.004). Univariate predictors of MACE were: evidence of previous stent restenosis, previous myocardial infarction, and a small vessel (< or =2.75 mm). However, the only independent predictor (Cox regression) of a MACE was previous stent restenosis (hazard ratio 3.85, 95% confidence interval, 1.46-10.18; P=.007). At one year, the TLR rate was also higher in patients with previous stent restenosis (31.3% vs 8.3%; P=.008), in those with small vessels, and in diabetics. Previous stent restenosis and a small vessel were independent predictors of TLR.


CONCLUSIONS
Restenosis of a previous stent is a strong predictor of major adverse events in patients undergoing a second conventional stent implantation at a different location because of coronary disease progression.
Morales
Francisco J
FJ
Servicio de Cardiología, Hospital Universitario Puerto Real, Puerto Real, Cádiz, Spain. franjmo@wanadoo.es
Martínez-Romero
Pedro
P
Lozano
Javier
J
Oneto
Jesús
J
López-Sinoga
Marisol
M
Martínez-García
Manuel
M
Martínez-Morentín
Eduardo
E
González-Pérez
Pablo
P
D000368:Aged; D000704:Analysis of Variance; D023903:Coronary Restenosis / Q000401:mortality / Q000601:surgery*; D023921:Coronary Stenosis / Q000401:mortality / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D011379:Prognosis; D019233:Retreatment / Q000379:methods; D015607:Stents