Black A J, Anderson H V, Roubin G S, Powelson S W, Douglas J S, King S B
Andreas Gruentzig Cardiovascular Center, Emory University Hospital, Atlanta, Georgia 30032.
J Am Coll Cardiol. 1988 Apr;11(4):714-8. doi: 10.1016/0735-1097(88)90201-x.
To identify the correlates of a second restenosis after repeat percutaneous coronary angioplasty, the records of 384 patients with single vessel disease who underwent repeat angioplasty for restenosis complicating a first elective angioplasty were examined. A second restenosis occurred in 47 (31%) of 151 patients having angiographic follow-up. Univariate correlates of a second restenosis were an interval between the first and second angioplasty less than 5 months (41 versus 20% of patients had restenosis, p less than 0.01), male gender (35 versus 12%, p less than 0.05), lesions length greater than or equal to 15 mm before the second angioplasty (62 versus 28%, p less than 0.05), diameter stenosis greater than 90% before the second angioplasty (67 versus 29%, p less than 0.05), final gradient greater than 20 mm Hg after the second angioplasty (52 versus 28%, p less than 0.05) and an additional site requiring dilation at the time of the second angioplasty (50 versus 29%, p = 0.10). Multivariate predictors of a second restenosis were an interval of less than 5 months between the first and the second angioplasty (p = 0.001), male gender (p = 0.001), lesion length greater than or equal to 15 mm before the second angioplasty (p = 0.001) and the need to have an additional site dilated at the time of the second angioplasty (p = 0.002). Patients at increased risk of restenosis after the second angioplasty can be identified and may serve as a useful population for intervention studies.
为了确定再次经皮冠状动脉腔内血管成形术后再次发生再狭窄的相关因素，我们检查了384名单支血管病变患者的记录，这些患者因首次择期血管成形术后发生再狭窄而接受了再次血管成形术。151例接受血管造影随访的患者中有47例（31%）发生了再次再狭窄。再次再狭窄的单因素相关因素包括：首次和第二次血管成形术之间的间隔时间少于5个月（再狭窄患者比例分别为41%和20%，p<0.01）、男性（分别为35%和12%，p<0.05）、第二次血管成形术前病变长度大于或等于15mm（分别为62%和28%，p<0.05）、第二次血管成形术前直径狭窄大于90%（分别为67%和29%，p<0.05）、第二次血管成形术后最终压差大于20mmHg（分别为52%和28%，p<0.05）以及第二次血管成形术时需要额外扩张的部位（分别为50%和29%，p = 0.10）。再次再狭窄的多因素预测因素包括：首次和第二次血管成形术之间的间隔时间少于5个月（p = 0.001）、男性（p = 0.001）、第二次血管成形术前病变长度大于或等于15mm（p = 0.001）以及第二次血管成形术时需要对额外部位进行扩张（p = 0.002）。可以识别出第二次血管成形术后再狭窄风险增加的患者，这些患者可作为干预研究的有用人群。
