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Clinical and angiographic factors associated with asymptomatic restenosis after percutaneous coronary intervention

P N Ruygrok1, M W Webster, V de Valk

  • 1Cardialysis, Westblaak 92, 3012 KM Rotterdam, Netherlands. pruygrok@ahsl.co.nz

Circulation
|November 7, 2001
PubMed

Insights

About half of patients with angiographic restenosis after percutaneous coronary intervention experience no symptoms. Male sex, larger vessel diameter, and less severe lesions predict silent restenosis.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Angiographic restenosis is a common complication following percutaneous coronary intervention (PCI).
  • Distinguishing between asymptomatic and symptomatic restenosis is crucial for patient management.
  • Previous studies have explored factors influencing restenosis, but a comprehensive analysis of silent restenosis is needed.

Purpose of the Study:

  • To compare clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after PCI.
  • To identify predictors of silent restenosis in patients undergoing coronary revascularization.

Main Methods:

  • Analysis of pooled data from 10 major clinical trials (BENESTENT I, II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, ROSE).
  • Inclusion of 2690 patients with angiographic restenosis and 6-month follow-up angiography.
  • Multivariate analysis of 46 clinical and angiographic variables to identify predictors of asymptomatic restenosis.

Main Results:

  • Restenosis occurred in 607 patients, with 55% being clinically silent.
  • Univariate predictors of asymptomatic restenosis included male sex, absence of nitrate/calcium channel blocker therapy, greater reference diameter, and lesser lesion severity.
  • Multivariate analysis identified male sex, greater follow-up reference diameter, and lesser 6-month lesion severity as independent predictors of silent restenosis.

Conclusions:

  • Approximately half of patients with angiographic restenosis remain asymptomatic.
  • Male sex, larger reference vessel diameter at follow-up, and less severe lesion at 6-month angiography are key predictors of silent restenosis.
  • These findings may aid in risk stratification and personalized follow-up strategies for patients post-PCI.
Abstract

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