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Updated: Oct 2, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
[Long term outcome in patients with and without restenosis after coronary angioplasty]
T Przewłocki1, W Ryniewicz, A Sokołowski
1Klinika Chorób Serca i Naczyń Instytutu Kardiologii CM UJ Krakowski Szpital Specjalistyczny im. Jana Pawła II 31-202 Kraków, ul. Pradnicka 80.
Insights
Restenosis after coronary angioplasty leads to more heart attacks and repeat procedures, but not increased mortality. Identifying and managing restenosis is crucial for improving patient outcomes after percutaneous coronary revascularisation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- Restenosis following percutaneous coronary revascularisation remains a significant clinical challenge.
- Long-term outcomes for patients with restenosis after angioplasty are not well-established, with limited and conflicting study results.
- Repeat angioplasty is the common treatment for restenosis, but its long-term impact requires further investigation.
Purpose of the Study:
- To evaluate the long-term impact of restenosis on patient outcomes after percutaneous balloon coronary angioplasty (PTCA).
- To identify risk factors and consequences associated with restenosis in patients undergoing PTCA.
- To assess the association between restenosis and subsequent cardiac events, interventions, and functional status.
Main Methods:
- Retrospective analysis of 567 patients who underwent successful PTCA between 1987 and 1996.
- Patients were divided into two groups: those with restenosis (n=188) and those without restenosis (n=379) based on follow-up angiography and angina symptoms.
- Comparison of clinical characteristics, procedural details, long-term outcomes (mortality, myocardial infarction, atherosclerosis progression, re-interventions), and functional status (CCS criteria).
Main Results:
- Restenotic patients were older, more frequently presented with unstable angina, and had undergone multivessel/multilesion angioplasty.
- Despite similar 5-year mortality rates, restenotic patients experienced significantly higher rates of myocardial infarction (8.0% vs. 3.2%), atherosclerosis progression (37.2% vs. 15.0%), and repeat interventions (37.2% vs. 15.0%).
- Logistic regression identified restenosis as an independent risk factor for myocardial infarction, repeat interventions (including multiple ones), and cardiac events, but not mortality.
Conclusions:
- Restenosis after PTCA is associated with poorer long-term outcomes, including increased risk of myocardial infarction and need for further interventions.
- While restenosis does not significantly impact long-term mortality, it negatively affects patient prognosis and functional status.
- These findings underscore the importance of managing restenosis to mitigate adverse cardiac events and improve patient well-being post-angioplasty.
Abstract:
Restenosis at dilatation site still constitutes a significant limitation of percutaneous coronary revascularisation. Majority of patients with restenosis are treated with repeat angioplasty, although its impact on long-term outcome is still little known > Very few studies focused on this issue bring rather discrepant results. The present study is aimed at assessing the impact of restenosis on long-term outcome in patients treated with coronary angioplasty. A group of 567 patients, who in the years 1987-1996 had successfully undergone percutaneous balloon coronary angio-plasty (PTCA) at our Clinic, was retrospectively divided into two groups: a group comprising 188 patients (33.2%) suffering from recurrent angina in whom restenosis had been established through control angiography, and a group comprising 379 patients (66.8%) who during the observation period exhibited no angina symptoms, or in whom the control angiography did not reveal restenosis. The restenotic patients were older (p = 0.007), more frequently exhibited symptoms of unstable angina upon PTCA (p < 0.0001), and there were also fewer smokers among them (p = 0.02). Furthermore, restenotic patients more frequently had multivessel and multilesion angioplasty (p = 0.025; p = 0.004, respectively). Restenosis after the first PTCA was treated by repeated angioplasty in 149 (79.3%) patients, 26 (13.8%) underwent CABG operation and 13 (6.9%) patients were treated pharmacologically without repeated revascularization. Within the 5-year observation period the mortality rate in both groups did not differ significantly (5.9% vs. 4.0%). Restenotic patients sustained myocardial infarctions more frequently (8.0% vs. 3.2%, p = 0.01), had significant atherosclerosis progression (37.2% vs. 15.0%, p < 0.0001), and were more frequently subjected to repeated interventions (37.2% vs. 15.0%, p < 0.0001), both PTCA (79.3% vs. 11.6% p < 0.0001) and CABG surgery (32.5% vs. 4.2%, p < 0.0001), as well as to multiple re-interventions (31.9% vs. 4.8%, p < 0.0001), in comparison with the non-restenotic ones. Analysis of functional status of patients assessed in compliance with the CCS criteria at the end of the observation period proved that significantly more non-restenotic patients did not experience angina, or experienced it rather sporadically (CCS Class 0 and 1). Logistic regression uni- and multivariate analysis proved that restenosis is an independent risk factor of myocardial infarction, reinterventions--also multiple ones--and cardiac events, although not mortality.
