title: [Previous restenosis as a prognostic indicator in new conventional stent implantation at a different location].
abstract: 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.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Puerto Real, Puerto Real, Cádiz, Spain. franjmo@wanadoo.es
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Morales
authors.forename: Pedro
authors.initials: P
authors.lastname: Martínez-Romero
authors.forename: Javier
authors.initials: J
authors.lastname: Lozano
authors.forename: Jesús
authors.initials: J
authors.lastname: Oneto
authors.forename: Marisol
authors.initials: M
authors.lastname: López-Sinoga
authors.forename: Manuel
authors.initials: M
authors.lastname: Martínez-García
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martínez-Morentín
authors.forename: Pablo
authors.initials: P
authors.lastname: González-Pérez
mesh_terms: 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