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Restenosis and progression of coronary atherosclerosis after coronary angioplasty
Insights
Restenosis after angioplasty occurs faster than atherosclerosis progression in other coronary segments. This study found no significant link between restenosis and disease progression in coronary arteries post-angioplasty.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Biology
Background:
- Coronary angioplasty is a common intervention for coronary artery disease.
- Restenosis and atherosclerosis progression are key concerns after angioplasty.
Purpose of the Study:
- To investigate the relationship between restenosis at the angioplasty site and atherosclerosis progression in other coronary segments.
- To compare the temporal development of restenosis and disease progression.
Main Methods:
- Prospective study of 98 patients with 110 coronary stenoses treated with angioplasty.
- Early (5 months) and late (34 months) angiographic restudies were performed.
- Restenosis and atherosclerosis progression were defined and quantified based on luminal diameter changes.
Main Results:
- Early restenosis (≥50% diameter stenosis) occurred in 38% of patients.
- Atherosclerosis progression (≥20% diameter decrease) was observed in 13% of patients with restenosis and 11% without at early restudy (p=NS).
- At late restudy, progression occurred in 33% of patients with restenosis and 38% without (p=NS), indicating no significant association.
Conclusions:
- Restenosis develops more rapidly than atherosclerosis progression in untreated segments after angioplasty.
- No significant correlation was found between restenosis and the progression of atherosclerosis in other coronary segments.
Abstract:
The relation between restenosis and progression of atherosclerosis in other coronary segments after angioplasty was studied in 98 consecutive patients with 110 coronary stenoses successfully treated with angioplasty. At early angiographic restudy (5 +/- 2 months after angioplasty) 37 patients (38%) had restenosis (defined as a stenosis greater than or equal to 50% of the luminal diameter or loss of greater than or equal to 50% of the gain achieved by angioplasty); progression of atherosclerosis was observed in 4 patients with and 7 without restenosis (13 versus 11%, p = NS). Ninety of the 98 patients underwent a late angiographic restudy a mean of 34 +/- 11 months after angioplasty. Late restenosis was found in one patient. Progression of coronary artery disease (defined as a greater than or equal to 20% decrease in the diameter of a vessel initially narrowed by greater than or equal to 50% or a greater than or equal to 30% decrease when the initial stenosis was less than 50%) was examined in relation to restenosis in 85 of the 90 patients. It occurred in 9 of 27 patients with and 22 of 58 patients without restenosis (33 versus 38%, p = NS). Restenosis developed more rapidly than did progression of disease. Diameter stenosis increased from 35 +/- 8 to 73 +/- 11% at the early restudy in lesions with restenosis; in lesions with disease progression it increased from 9 +/- 18 to 20 +/- 28% (p less than 0.001) at the early restudy to 53 +/- 21% (p less than 0.001) at the late restudy.(ABSTRACT TRUNCATED AT 250 WORDS)