RELATION BETWEEN PROGRESSION OF ATHEROSCL EROSIS AND POST CORONARY ANGIOPLASTY RESTENOSIS

The authors undertook a retrospective study of medium-term coronary an giographic controls of a group (Or) of patients (pts) who had undergon e coronary angioplasty for rapidly progressive lesions, to determine w hether the rate of progression of a coronary stenosis before angioplas ty affected the risk of restenosis. 89 pts underwent primary angioplas ty with absence of restenosis at 6 months, but required another angiop lasty for another lesion. Angiographic follow-up after the 2nd procedu re was performed in 86 pts (96 %). The coronary lesion dilated at the 2nd angioplasty procedure was analysed quantitatively with four measur ements: one immediately before angioplasty one after, one at the 6 mon ths control, and finally. one measurement 6 months before the angiopla sty during the procedure on the Ist site. Multivariate statistical ana lysis showed that the only predictive factor of post-angioplasty loss in the general population was the immediate gain (F = 11.82; p < 0.005 ). On the other hand, no correlation was found between progression of the lesion before angioplasty and loss. The rapidly progressive nature of the lesion was defined with a threshold of 0.4 mm, corresponding t o the variability of the quantitative angiographic system. Analysis of the procedure parameters showed a lower inflation pressure in the Or with rapidly progressive lesions (6.58 +/- 21 atm vs 7.63 +/- 1.96 atm ; p < 0.05). The immediate gain was significantly greater in the rapid ly progressive lesion Or (0.82 +/- 0.34 vs 0.67 +/- 0.29 mm; p = 0.05) . The loss at the 6 months control was identical in the two Or (0.31 /- 0.50 vs 0.31 +/- 0.42 mm : p < 0.05). The loss/gain ratio was also comparable (0.37 +/- 0.76 vs 0.45 +/- 0.52; p > 0.05). These results s how that rapidly progressive atherosclerosis does not increase the ris k of post-angioplasty restenosis.