Fukuzawa S, Ozawa S, Katagiri M, Watanabe H
Division of Cardiology, Funabashi Municipal Medical Center.
J Cardiol. 1995 Feb;25(2):63-8.
Follow-up angiography after percutaneous transluminal coronary angioplasty (PTCA) often demonstrates "moderate" angiographic restenosis, but the need for subsequent revascularization is difficult to determine. We examined the clinical outcome of patients with moderate angiographic restenosis after PTCA. Follow-up angiography performed in 96 patients within 4 months showed light restenosis (LR:stenosis < 40%) in 52 patients, moderate restenosis (MR:40-70%) in 21, and severe restenosis (SR: > 70%) in 23. One of 21 patients with MR underwent repeat PTCA after a positive exercise test. The remaining 20 patients with MR were compared with 52 with LR (follow-up: 12-18 months). Five patients with MR underwent repeat PTCA for recurrence of angina in the follow-up period. Log rank analysis of the Kaplan-Meier estimates for event-free survival (death, myocardial infarction CABG, re-PTCA) showed the outcome was significantly worse for MR patients. However, 14 MR patients who had no cardiac event demonstrated regression of stenosis at 1-year follow-up angiography (58.2% to 45.4%). Moderate restenosis at angiographic follow-up was observed in 30% of all PTCA patients. Moderate restenosis patients have a worse prognosis than light restenosis patients. Adequate follow-up management is mandatory for moderate restenosis patients.
经皮腔内冠状动脉成形术（PTCA）后的随访血管造影常显示“中度”血管造影再狭窄，但后续血运重建的必要性难以确定。我们研究了PTCA术后中度血管造影再狭窄患者的临床结局。96例患者在4个月内进行的随访血管造影显示，52例患者为轻度再狭窄（LR：狭窄<40%），21例为中度再狭窄（MR：40 - 70%），23例为重度再狭窄（SR：>70%）。21例MR患者中有1例在运动试验阳性后接受了重复PTCA。其余20例MR患者与52例LR患者进行了比较（随访12 - 18个月）。5例MR患者在随访期间因心绞痛复发接受了重复PTCA。对无事件生存（死亡、心肌梗死、冠状动脉旁路移植术、再次PTCA）的Kaplan - Meier估计值进行对数秩分析显示，MR患者的结局明显更差。然而，14例无心脏事件的MR患者在1年随访血管造影时显示狭窄程度减轻（从58.2%降至45.4%）。所有PTCA患者中30%在血管造影随访时观察到中度再狭窄。中度再狭窄患者的预后比轻度再狭窄患者差。对中度再狭窄患者进行充分的随访管理是必要的。
