PRIOR RESTENOSIS PREDICTS RESTENOSIS AFTER CORONARY ANGIOPLASTY OF A NEW SIGNIFICANT NARROWING

To determine the influence of a history of restenosis on subsequent restenosis after percutaneous transluminal coronary angioplasty (PTCA) of a new significant narrowing, the records of 100 patients who underwent successful PTCA at another site ("new narrowing PTCA") greater-than-or-equal-to 2 months after successful initial PTCA were retrospectively reviewed. Patients were grouped according to whether initial PTCA resulted in restenosis, which was determined by angiographic follow-up greater-than-or-equal-to 3 months after initial PTCA. Patients in group 1 did not have restenosis after initial PTCA (n = 50), whereas patients in group 2 did (n = 40). All patients were followed for recurrent symptoms, with serial exercise tests, for greater-than-or-equal-to 6 months after new narrowing PTCA. Clinically suspected and angiographically confirmed restenosis occurred in 11 of 50 (22%) patients and 12 of 63 (19%) narrowing in group 1, and in 20 of 40 (50%) patients and 22 of 48 (46%) narrowings in group 2 (p < 0.01 for patients, p < 0.002 for narrowings). Multivariate analysis identified that prior restenosis (p < 0.02, odds ratio 3.4), left anterior descending artery location of stenosis (p < 0.04, odds ratio 3.0), and severity of stenosis before PTCA (p < 0.02, odds ratio 1.8) were independently associated with restenosis after new narrowing PTCA. In conclusion, prior restenosis is an independent risk factor for subsequent restenosis after new narrowing PTCA.