Document Detail


Long-term follow-up after deferring angioplasty in asymptomatic patients with moderate noncritical in-stent restenosis.
MedLine Citation:
PMID:  11501607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Many patients with in-stent restenosis (ISR) are angina-free, but the optimal treatment for these patients remains uncertain. HYPOTHESIS: In cases with asymptomatic moderate noncritical ISR. deferral of the intervention may be safe and associated with favorable clinical outcome. METHODS: We evaluated the long-term clinical outcome of asymptomatic patients (Group 1, n = 98) with moderate noncritical ISR (< 70% diameter stenosis) after intervention was deferred, and compared it with that of patients (Group 2, n = 655) without restenosis. After repeat angioplasty was deferred, all patients were treated medically and later underwent angioplasty only in the case of clinical recurrence. RESULTS: Baseline characteristics were similar between the two groups. Clinical follow-up was available in all patients at 26.3+/-15.9 months. Twenty patients died during the follow-up: 1 in Group 1 and 19 in Group 2. Target lesion revascularization was performed in 3 patients in Group 1 and 11 patients in Group 2 during follow-up (p = NS), and new lesion revascularization in 2 patients in Group 1 and 27 patients in Group 2 (p = NS). Event-free survival rate (cardiac death, nonfatal myocardial infarction, repeat revascularization) was 86.7+/-6.1% in Group 1 and 84.8+/-2.2% in Group 2 at the end of follow-up (p = NS). Major adverse cardiac events were only associated with the presence of diabetic mellitus (hazards ratio 2.65, 95% confidence interval [CI] 1.48-4.73, p<0.01). The percentage of patients receiving antianginal medication was similar between the two groups at the end of the study (p = NS). CONCLUSIONS: Asymptomatic patients with moderate noncritical ISR have a good prognosis and similar clinical outcome as those without ISR, suggesting that it may be safe to defer repeat angioplasty in these patients until angina recurrence.
Authors:
J H Lee; C W Lee; S W Park; M K Hong; J J Kim; K S Rhee; S J Park
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  24     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-14     Completed Date:  2001-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  551-5     Citation Subset:  IM    
Affiliation:
Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Restenosis / diagnosis,  mortality,  surgery*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Severity of Illness Index
Stents*
Survival Rate
Time Factors

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


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