Greater late lumen loss after successful coronary balloon angioplasty in the proximal left anterior descending coronary artery is not explained by extent of vessel wall damage or plaque burden

Citation
Wem. Kok et al., Greater late lumen loss after successful coronary balloon angioplasty in the proximal left anterior descending coronary artery is not explained by extent of vessel wall damage or plaque burden, J AM COL C, 35(2), 2000, pp. 382-388
Citations number
30
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
ISSN journal
07351097 → ACNP
Volume
35
Issue
2
Year of publication
2000
Pages
382 - 388
Database
ISI
SICI code
0735-1097(200002)35:2<382:GLLLAS>2.0.ZU;2-C
Abstract
OBJECTIVES We investigated whether the greater late lumen loss after corona ry balloon angioplasty in the proximal left anterior descending artery (P-L AD) compared with that in other segments might be related to differences in vascular dimensions or morphology as determined by angiography and intrava scular ultrasound imaging. BACKGROUND The greater late lumen loss after angioplasty in the P-LAD that has been observed in several studies has not been explained. METHODS We studied 178 patients and 194 coronary artery lesions by quantita tive angiography and 30 MHz intravascular ultrasound imaging after successf ul balloon angioplasty, Vessel wall morphology was compared among three pro ximal and three nonproximal segments. Follow-up quantitative angiography fo r late lumen loss calculation was performed in 168 lesions. Multivariate an alysis was used to determine predictors of late lumen loss. RESULTS Absolute and relative late loss were significantly greater at the P -LAD compared with the pooled group of other segments (0.42 +/- 0.60 mm vs. 0.10 +/- 0.48 mm, p = 0.0008 and 0.14 +/- 0.24 vs. 0.03 +/- 0.17, p < 0.00 1). Also, a greater percentage of calcific lesions (65% vs. 44%, p = 0.034) , a lower incidence of rupture (51% vs. 74%, p = 0.009) and a larger refere nce segment plaque area (5.4 +/- 2.2 mm(2) vs. 4.7 +/- 1.9 mm(2), p = 0.05) were found in the P-LAD. In multivariate analysis however, these variables were not predictive of late loss. CONCLUSIONS Greater late lumen loss after coronary balloon angioplasty of t he P-LAD is not explained by differences in atherosclerotic plaque burden o r in vessel wall damage. (J Am Coll Cardiol 2000;35:382-8) (C) 2000 by the American College of Cardiology.