LONG-TERM OUTCOME FOLLOWING SUCCESSFUL REOPENING OF ABRUPT CLOSURE AFTER CORONARY ANGIOPLASTY

Abrupt closure after angioplasty is often successfully treated by repe at dilation. Long-term follow-up, including 6-month repeat catheteriza tion and clinical evaluation, was obtained in 1,056 patients treated w ith acute (n = 335) or elective (n = 721) coronary angioplasty to eval uate the impact of successful reopening of abrupt closure. Abrupt clos ure occurred in 13.5% of patients and was successfully reopened in 58% . Adverse outcomes including restenosis, bypass surgery, myocardial in farction and repeat angioplasty were compared between patients with su ccessfully treated abrupt closure and with successful procedures (resi dual diameter stenosis less-than-or-equal-to 50%) abrupt closure. For patients with acute angioplasty, the restenosis rates (>50% diameter s tenosis at follow-up) were 64% for those with successfully treated abr upt closure versus 36% for those with successful procedures without ab rupt closure (p < 0.01). In addition, subsequent myocardial infarction (12 vs 3%; p = 0.01) and repeat angioplasty (21 vs 10%; p = 0.03) wer e more frequent in the group with abrupt closure. For patients with el ective angioplasty, restenosis was 43% in those with successfully trea ted abrupt closure versus 45% in those without abrupt closure (p = NS) . Subsequent death and myocardial infarction were more frequent in pat ients with abrupt closure (death: 12 vs 3% [p < 0.01]; myocardial infa rction: 13 vs 3% [p < 0.01]). Long-term adverse events are increased i n patients with successfully treated abrupt closure to those with succ essful procedures without abrupt closure.