Luijten H E, Plante S, Leborgne O, Beatt K J, Suryapranata H, de Feyter P J, van den Brand M, Serruys P W
Département de cardiologie, Université Erasmus, Rotterdam, Pays-Bas.
Arch Mal Coeur Vaiss. 1990 Mar;83(3):305-12.
The aim of this prospective study was to compare the incidence of restenosis after percutaneous transluminal coronary angioplasty (PTCA) in patients with stable and unstable angina before the procedure. Between January 1984 and February 1986, 344 patients with stable angina and 228 patients with unstable angina underwent PTCA. The primary success rate was 86.3 per cent in patients with stable angina (297 patients) and 87.7 per cent in patients with unstable angina (200 patients). The patients were recalled for systematic control coronary arteriography at 30, 60, 90, 120 or 150 days, and was obtained in 83.8 per cent of patients with stable angina and in 86 per cent of patients with unstable angina. The degree of stenosis before and the angiographic changes after PTCA and at control coronary arteriography were evaluated by a computer-assisted automatic contour detection system. The three criteria of restenosis were: 1) over 50 per cent loss of the benefit of PTCA, 2) residual post-PTCA stenosis increasing from less than 50 per cent to more than 50 per cent at control arteriography, 3) a decrease in the minimum intraluminal diameter of at least 0.72 mm with respect to the immediate post-PTCA result. A comparison between the two groups of patients showed that the average age was slightly greater in patients with unstable angina (56 +/- 9 years vs 58 +/- 9 years, p = 0.047). Apart from this difference, the two groups were comparable with regards to the average number of lesions dilated per patient, the date of control arteriography, the severity of the coronary artery disease and previous bypass surgery, angioplasty and infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
这项前瞻性研究的目的是比较经皮腔内冠状动脉成形术(PTCA)术前稳定型和不稳定型心绞痛患者再狭窄的发生率。1984年1月至1986年2月期间,344例稳定型心绞痛患者和228例不稳定型心绞痛患者接受了PTCA。稳定型心绞痛患者(297例)的主要成功率为86.3%,不稳定型心绞痛患者(200例)为87.7%。在30、60、90、120或150天时对患者进行系统性对照冠状动脉造影复查,稳定型心绞痛患者的复查率为83.8%,不稳定型心绞痛患者为86%。通过计算机辅助自动轮廓检测系统评估PTCA术前的狭窄程度以及PTCA术后和对照冠状动脉造影时的血管造影变化。再狭窄的三个标准为:1)PTCA获益丧失超过50%;2)对照血管造影时,PTCA术后残余狭窄从小于50%增加到大于50%;3)相对于PTCA术后即刻结果,最小管腔直径至少减少0.72 mm。两组患者比较显示,不稳定型心绞痛患者的平均年龄略大(56±9岁对58±9岁,p = 0.047)。除此之外,两组在每位患者扩张病变的平均数量、对照血管造影日期、冠状动脉疾病严重程度以及既往搭桥手术、血管成形术和梗死方面具有可比性。(摘要截短于250字)