LUMINAL NARROWING AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY - A MULTIVARIATE-ANALYSIS OF CLINICAL, PROCEDURAL AND LESION RELATEDFACTORS AFFECTING LONG-TERM ANGIOGRAPHIC OUTCOME IN THE PARK STUDY

Background: Long term luminal renarrowing after successful coronary ba lloon angioplasty is a major limitation of the technique. Knowledge of factors which influence long term luminal re-narrowing could be very valuable in selecting appropriate patients or lesions for the procedur e and may therefore improve the medium term prognosis after angioplast y. Furthermore, modification or control of the identified risk factors could reduce overall restenosis. Additionally, identification of such factors would assist in the selection of high risk patients, who coul d then constitute the target population for pharmacological interventi on studies. Thus the aims of the present study were to find independen t patient, lesion and procedural related risk factors for the restenos is process. Methods and Results: Quantitative angiography was performe d on 742 successfully dilated lesions at angioplasty and 6 months foll ow-up. Long-term luminal re-narrowing was defined as the absolute chan ge in minimal luminal diameter (MLD) from post PTCA to follow up. Univ ariate and multiple linear regression analysis of all available clinic al, lesion and procedural variables was performed to identify variable s with a significant contribution to the prediction of change in MLD. Gain in MLD at angioplasty, pre PTCA MLD, total inflation time and mal e sex were positively related to change in MLD while a positive smokin g history, vessel and maximum balloon size were negatively related. Th e overall prediction of the model was poor (R2 - 0.14) suggesting that many factors influencing the process are still outside our understand ing Conclusions: These results indicate that re-narrowing after succes sful PTCA is a process which can be influenced by a number of clinical , angiographic and procedural characteristics but cannot yet be accura tely predicted by these.