Luminal narrowing after percutaneous transluminal coronary angioplasty. A study of clinical, procedural, and lesional factors related to long-term angiographic outcome. Coronary Artery Restenosis Prevention on Repeated Thromboxane Antagonism (CARPORT) Study Group.

Rensing, Benno J.; Hermans, Walter R.M.; Vos, Jacobus Cornelis de; Tijssen, Jan G.P.; Rutch, W; Danchin, Nicolás; Heyndrickx, Guy R.; Mast, E. Gijs; Wijns, William; Serruys, Patrick W.

doi:10.1161/01.cir.88.3.975

Cited by 123 publications

(50 citation statements)

References 52 publications

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“…11 ) The predictors of acute complications such as female gender, 12) advanced age, 13) lesion characteristics, 14) and haemostatic variables 15) have a poor practical value. 1,4,5,13,16,17) The results of this study extend our previous observations, demonstrating the predictive value of measuring plasma levels of IL-8 for early complications after coronary interventions.…”

Section: Discussionmentioning

confidence: 99%

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

Qi¹,

Li²,

Gu³

et al. 2003

Jpn Heart J

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SUMMARYThe aim of the present study was to investigate the prognostic value of plasma interleukin-8 (IL-8) for early complications after percutaneous coronary intervention (PCI).The pre-and postprocedural plasma levels of IL-8 and serum C-reactive protein (CRP) were examined by immunoassay, and the expression of CD11b/CD18 on neutrophils was assessed by flow cytometry. Early complications (abrupt occlusion, threatened abrupt occlusion, early recurrence of ischemia, myocardial infarction, cardiac sudden death, and target vessel revascularization) occurred intra-procedure and 30 days after PCI and were observed in 121 consecutive patients with coronary heart disease.Sixteen patients with early complications had high preprocedural levels and high postprocedural differentials of IL-8, CRP, and CD11b/CD18 compared to those without complications (all P < 0.05). The occurrence of complications showed a significant increase in the patients according to the tertiles of IL-8, CRP, and CD11b / CD18. Preprocedural levels of IL-8 (RR = 5.864, CI = 1.658 −20.734, P = 0.006) and diabetes (RR = 1.587, CI = 1.246 − 2.132, P = 0.038) were independent predictors of early complications. There were significant correlations in the postprocedural differential between IL-8 and CD11b/ CD18 (r = 0.776, P = 0.002) in patients with complications.The results reveal that the early complications after PCI contribute to preprocedural inflammatory responses. Normal levels of IL-8 may be powerful negative predictors of early complications in patients with CHD following PCI. (Jpn Heart J 2003; 44: 451-461) Key words: Percutaneous coronary intervention (PCI), IL-8, C-reactive protein (CRP), CD11b/CD18, Complications PERCUTANEOUS coronary intervention (PCI) is an established myocardial revascularization procedure. However, the high initial success rate is limited by the risk of acute complications, which range from 5% to 30% in unstable patients.1,2) It would be desirable to preprocedurally predict the risks of complications related to PCI in patients who might benefit from early prevention and addiFrom

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Section: Discussionmentioning

confidence: 99%

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

Qi¹,

Li²,

Gu³

et al. 2003

Jpn Heart J

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“…Similar findings have also emerged from studies with PTCA. 19,22 It is obvious that the same lumen loss entails many more consequences for small vessels than for larger vessels. A greater balloon-to-vessel ratio was used in the small-vessel group, which may have led to greater vessel wall injury and more considerable reactive neointimal hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

Vessel Size and Long-Term Outcome After Coronary Stent Placement

et al. 1998

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Background —The role of coronary stenting in the treatment of patients with small vessels is not well defined. The purpose of this study was to investigate the influence of vessel size on long-term clinical and angiographic outcome after coronary stent placement. Methods and Results —The study comprised 2602 patients with successful stent implantation for symptomatic coronary artery disease. Patients were subdivided into 3 equally sized groups (tertiles) according to vessel size, with respective ranges of <2.8, 2.8 to 3.2, and >3.2 mm. Event-free survival at 1 year was 69.5% in the group with smaller vessels, 77.5% in the second group, and 81% in the group with larger vessels ( P <0.001). Late lumen loss was similar between the 3 groups (1.12±0.73, 1.12±0.79, and 1.09±0.88 mm, respectively). Angiographic restenosis rate was significantly higher in the small-vessel group (38.6%, 28.4%, and 20.4% in groups 1, 2, and 3, respectively; P <0.001). The analysis identified subgroups with different risk for restenosis even among patients with small vessels. Within this group, the restenosis rate may be as low as 29.6% in patients without additional risk factors and as high as 53.5% in patients with diabetes and complex lesions. Conclusions —Patients with small vessels present a higher risk for an adverse outcome after coronary stent placement because of a higher incidence of restenosis. However, the unusually high risk for restenosis is confined to those patients with small vessels who have concomitant risk factors such as diabetes and complex lesions.

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“…1 Diabetic patients appeared to have a higher incidence of myocardial infarction and a greater need for repeated revascularization after coronary angioplasty. 20,21 In fact, the restenosis rate of diabetic patients who underwent coronary angioplasty has been reported to be high, [22][23][24][25][26][27][28] mainly because of the small and diffuse narrowing of diseased coronary arteries that is frequently seen in diabetic patients, which makes it difficult to achieve the optimal large lumen size and is followed by high rate of residual stenosis and restenosis. 29,30 Therefore, coronary angioplasty in diabetic patients has fewer advantages compared with non-diabetic patients.…”

Section: Diabetes Mellitus and Long-term Prognosismentioning

confidence: 99%

Balloon Coronary Angioplasty and Long-Term Survival of Non-Diabetic Patients With Isolated Severe Left Anterior Descending Coronary Artery Disease.

Tomita

Miyazaki

Morii

et al. 2002

Circ J

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ecently, the BARI study reported that the beneficial effect of bypass surgery on long-term survival was more prominent than that of coronary angioplasty in diabetic patients with multivessel coronary artery disease, 1 related, at least in part, to the disadvantage of coronary angioplasty in such patients; that is, the coronary narrowing in diabetic patients is usually diffuse and small, which results in a small minimal lumen diameter after the intervention and a high restenosis rate. 2,3 Another possible explanation is the general disadvantage of coronary angioplasty in achieving complete revascularization compared with bypass surgery in patients with multivessel disease. In fact, multivessel angioplasties were attempted in 70% of the patients in the BARI study and immediate success was achieved in 78%. 1 Thus, incomplete revascularization may contribute to the difference of survival in the 2 groups. To avoid this problem in the interpretation of the study results from patients with multivessel coronary disease, we investigated the long-term prognosis in diabetic and non-diabetic patients with isolated proximal left anterior descending coronary artery (LAD) disease, because LAD disease has Circulation Journal Vol. 66, June 2002 been reported to have significant survival importance. 4 From 1985From to 1994 consecutive patients who underwent their first elective coronary angiography were identified from the computer database at the National Cardiovascular Center and of these, 681 had isolated proximal LAD disease with more than 90% stenosis. Fourteen patients treated with bypass surgery were excluded and the remaining 667 were enrolled in the present study. They were divided into 2 groups according to their diabetic status: diabetes mellitus (DM) or abnormal glucose tolerance (n=225) and non-diabetic (n=442). They were further subdivided into 2 groups according to the initial therapeutic choice: medical therapy (MED group) or percutaneous transluminal balloon coronary angioplasty (PTCA group). Our definitions of coronary risk factors were: hypertension was defined as more than 140 mmHg systolic blood pressure and/or 90 mmHg diastolic blood pressure; hyperlipidemia was defined as more than 220 mg/dl of total serum cholesterol; DM was diagnosed according to WHO criteria. 5 Methods Patients Coronary Angiography and AngioplastyDiagnostic coronary angiography and left ventriculography were performed using a non-ionic contrast medium (Iopamiron 370, Schering Inc or Iomeron, Eisai Inc). The cine-angiography equipment had a bi-plane system (Toshiba Although long-term survival of diabetic patients with multivessel coronary disease has been reported to be better in those treated with bypass surgery than with coronary angioplasty, it is unclear if diabetic patients who undergo coronary angioplasty show better long-term survival than those treated medically. Between 1985 and 1994, 667 consecutive patients with isolated severe (≥90% diameter stenosis) proximal left anterior descending (LAD) coronary artery disease were...

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Luminal narrowing after percutaneous transluminal coronary angioplasty. A study of clinical, procedural, and lesional factors related to long-term angiographic outcome. Coronary Artery Restenosis Prevention on Repeated Thromboxane Antagonism (CARPORT) Study Group.

Abstract: Renarrowing after successful PTCA as determined with contrast angiography is a process that cannot be accurately predicted by simple clinical, morphological, and lesion characteristics.

Cited by 123 publications

References 52 publications

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

Vessel Size and Long-Term Outcome After Coronary Stent Placement

Balloon Coronary Angioplasty and Long-Term Survival of Non-Diabetic Patients With Isolated Severe Left Anterior Descending Coronary Artery Disease.

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