Document Detail

Clinical variables related with in-stent restenosis late regression after bare metal coronary stenting.
MedLine Citation:
PMID:  17315615     Owner:  NLM     Status:  MEDLINE    
In-stent restenosis (ISR) has an incidence between 20% and 30% using bare metal stents. ISR late regression phenomenon (ISRLR) has been previously described, but clinical variables related with this phenomenon remain unclear. The aim of the study was to identify the variables related with ISRLR. METHODS: We identified from our data base 30 patients between November 1995 and September 2002 that fulfilled the following criteria: 1) Documented ISR at follow-up angiography (CA-1); 2) treated medically; and 3) Referred for a second follow-up angiography (CA-2). at least 3 months after CA-1. ISRLR was defined as a > 0.2 mm increase in MLD between CA-1 and CA-2, calculated as the 2-fold of our inter-observer variability. ISR late progression was defined as a > 0.2 mm decrease in minimum lumen diameter (MLD) between CA-1 and CA-2. RESULTS: At the time of CA-2 only 2 patients (6.7%) had symptoms related with the previously stented vessel. We found a mean MLD of 1.03+/-0.34 mm and 1.54+/-0.48 mm at CA-1 and CA-2 respectively (AMLD = 0.51 +/-0.34 mm; p < 0.001). Twenty four patients (80.0%) had ISRLR. Two variables were related to the presence or absence ISRLR: Current smoking at the time of coronary stenting (70.8% vs 20.0% respectively, p = 0.026) and acute coronary syndrome as clinical indication for coronary stenting (and 83.5% vs 40.0% respectively, p = 0.029). CONCLUSION: ISRLR is a frequent phenomenon in patients with ISR treated medically, probably contributing to the benign long-term clinical outcome that has been previously described in patients with asymptomatic or mildly symptomatic ISR. Current smoking at the time of coronary stenting and acute coronary syndrome as clinical indication for coronary stenting are associated with this phenomenon.
Alejandro Alcocer; Raúl Moreno; Rosana Hernández; María-José Pérez-Vizcayno; César Conde; Fernando Alfonso; Manel Sabaté; Javier Escaned; Camino Bañuelos; Luis Azcona; Carlos Macaya
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Archivos de cardiología de México     Volume:  76     ISSN:  1405-9940     ISO Abbreviation:  Arch Cardiol Mex     Publication Date:    2006 Oct-Dec
Date Detail:
Created Date:  2007-02-23     Completed Date:  2007-04-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101126728     Medline TA:  Arch Cardiol Mex     Country:  Mexico    
Other Details:
Languages:  eng     Pagination:  390-6     Citation Subset:  IM    
Division of Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography
Coronary Disease / therapy
Coronary Restenosis / diagnosis*,  radiography
Data Interpretation, Statistical
Follow-Up Studies
Heart Catheterization
Middle Aged
Patient Selection
Time Factors
Treatment Outcome
Reg. No./Substance:

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