IMMEDIATE AND 6-MONTH FOLLOW-UP RESULTS OF CORONARY ANGIOPLASTY FOR RESTENOSIS - ANALYSIS OF FACTORS PREDICTING RECURRENT CLINICAL RESTENOSIS

To determine the results of coronary angioplasty for a first restenosi s, the clinical, anatomic, and procedural data of 400 consecutive pati ents were compared with the data of 507 consecutive patients undergoin g a first angioplasty. After angioplasty for restenosis, emergency red ilatation had to be performed in only 0.7% of the patients versus 3.1% of the control group (p = 0.02); nevertheless, the major in-hospital event (death, myocardial infarction, emergency coronary surgery, cereb rovascular accident) rate for patients was only slightly lower (3.3% v s 4.2%, p = NS). During the 6-month follow-up period, there were no ca rdiac deaths and only two myocardial infarctions in the study group, b ut recurrent ischemia was more frequent (37% vs 31%, p = 0.05) and res ulted in considerably more elective coronary surgery (16% vs 2.6%, p = 0.001). In the study group, stepwise discriminant analysis revealed f our variables significantly related to the occurrence of a second rest enosis: time interval between first and second angioplasty, male gende r, severity of angina, and complexity of the restenotic lesions. Howev er, their individual predictive power was low. In conclusion, compared with angioplasty for primary lesions, angioplasty for restenosis was associated with fewer periprocedural complications and, after a 6-mont h follow-up, serious cardiac events were almost nonexistent but recurr ent ischemia was more frequent.