Document Detail


Incidence and risk factors predictive of unstable angina resulting from restenosis after percutaneous angioplasty of saphenous vein grafts.
MedLine Citation:
PMID:  11099984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The current study was designed to determine the incidence and risk factors for unstable angina resulting from restenosis in patients undergoing percutaneous transluminal coronary angioplasty (PTCA) of saphenous vein graft (SVG), about which little data are available. METHODS AND RESULTS: A retrospective analysis of a consecutive series of 212 patients undergoing PTCA of SVG was performed. Procedural success was achieved in 200 patients (94.3%) who formed the study group. During a follow-up of 16.8 +/- 10.2 months, 24.5% of patients presented with unstable angina resulting from restenosis. There was a higher prevalence of dyslipidemia (81. 6% vs 51.2%, P <.0002) and greater postprocedural residual stenosis (14.2% +/- 12.6% vs 7.1% +/- 11.0%, P =.007) in patients with unstable angina caused by restenosis compared with the remaining patient population. By multivariate analysis, dyslipidemia (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.64-8.39, P <.002) and to a lesser extent postprocedural residual stenosis (OR 1.04, 95% CI 1.01-1.07, P <.05) were predictive of unstable angina resulting from restenosis. Among dyslipidemic patients, those not on lipid-lowering drugs during the index procedure had a significantly higher incidence of unstable angina caused by restenosis than did those on lipid-lowering drugs (P <.05). CONCLUSION: Unstable angina caused by restenosis presents in as many as one fourth of patients undergoing PTCA of SVG. Dyslipidemia strongly, and to a lesser extent postprocedural residual stenosis, predicts its occurrence. Scrupulous attention to these modifiable risk factors may help reduce the incidence of unstable angina after SVG angioplasty.
Authors:
B Chandrasekar; M G Bourassa
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  140     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-20     Completed Date:  2001-01-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  827-33     Citation Subset:  AIM; IM    
Affiliation:
Research Center, Montreal Heart Institute, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina, Unstable / epidemiology*,  etiology,  therapy
Angioplasty, Transluminal, Percutaneous Coronary*
Antilipemic Agents / therapeutic use
Female
Graft Occlusion, Vascular / complications*,  epidemiology
Humans
Hyperlipidemias / complications*,  drug therapy,  epidemiology
Incidence
Male
Middle Aged
Odds Ratio
Prognosis
Quebec / epidemiology
Recurrence
Retrospective Studies
Risk Factors
Saphenous Vein / transplantation*
Treatment Failure
Chemical
Reg. No./Substance:
0/Antilipemic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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