Causes of Coronary Events After Successful Coronary Angioplasty Sugao Ishiwata 1 , Sigemoto Nakanishi 1 , Sinichiro Nishiyama 1 , Takashi Iwase 1 , Nobuyuki Komiyama 1 , Yoshiki Yanagishita 1 , Akira Seki 1 1Cardiovascular Center, Toranomon Hospital Keyword: 経皮的冠血管形成術 , 心事故 , 長期予後 , percutaneous transluminal coronary angioplasty , coronary events , long-term prognosis pp.477-481
Published Date 1995/5/15
DOI https://doi.org/10.11477/mf.1404901054
  • Abstract
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To determine the causes and incidence of coronary events after successful coronary angioplasty, we evaluated follow-up angiograms retrospectively from 60 patients (27 with myocardial infarction and 33 with new onset angina pectoris) with coronary events. These 60 patients were selected from among 930 consec-utive patients undergoing successful elective angioplas-ty between February 1984 and April 1994. Follow-up ratio was 64%. All patients had undergone follow -up catheterization two or more times. In this study, we excluded cases whose angina pectoris was due to short -term restenosis or to coronary artery bypass grafting.There were ten cases with fatal cardiac events during the period of follow-up reevaluation to confirm the presence of restenosis. All patients (n=15) with short -term (3.9±1.8 months) restenosis had non-Q wave infarction due to severe restenosis of the dilated site, which was a nonfatal complication. In contrast, except for two cases, culprit lesions in late onset coronary events in cases without short-term restenosis (n=45) were at undilated sites that were previously nonob-structive. These findings indicate that prexisting obstructive coronary lesions are not a future infarct site. Furthermore, previous dilated sites also showed long-term good patency (41 ± 23 months). We con-cluded that restenosis is unavoidable, however fatal complications due to restenosis are very rare. PTCA is particularly valuble in patients who do not develop restenosis after initial procedures, because of the long-term sustained efficacy of lesion dilatation. However, some patients developed new lesions at nondilated sites during long-term follow-up, so careful observation is needed.

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