[Rate of restenosis after PTCA in patients with terminal renal failure. A quantitative coronary angiography study]
- PMID: 9304313
- DOI: 10.1007/s003920050071
[Rate of restenosis after PTCA in patients with terminal renal failure. A quantitative coronary angiography study]
Abstract
Patients with end-stage renal disease (ESRD) have a high incidence of coronary artery disease. In 30-60% of these patients coronary artery disease can be demonstrated by coronary angiography often prompting myocardial revascularization. Previous studies on PTCA in patients with ESRD have suggested a high rate of procedural complications and restenosis. We studied the rate of restenosis after PTCA in 23 patients with chronic renal failure (17 males, 6 females, age: 52.5 +/- 18.3 years). After primarily successful PTCA all patients were restudied angiographically within 6-12 months. Using quantitative coronary angiography 13 patients (56%) demonstrated restenosis (stenosis > 50% luminal diameter). In 11 of these patients further revascularization therapy was indicated (6 x PTCA, 5 x CABG). Before follow-up angiography 12 patients demonstrated recurrence of angina pectoris, the sensitivity of clinical symptoms for angiographic restenosis was 69%. High concentrations of triglycerides (265 +/- 160 mg/dl), total cholesterol (258 +/- 53 mg/dl) with low HDL-levels (34 +/- 14 mg/dl) as well as elevated plasma levels of fibrinogen (481 +/- 114 mg/dl) were measured before PTCA. The mechanisms contributing to the high rate of coronary restenosis in patients with ESRD remain unclear, influence of lipid abnormalities, hemostatic factors and fibrinolytic state as well as primarily uremic factors have to be discussed. Prospective interventional studies are needed to address the relevance of PTCA for myocardial revascularization in this patient group.
Similar articles
-
Restenosis after elective coronary balloon angioplasty in patients with end stage renal disease: a case-control study using quantitative coronary angiography.Heart. 1997 Oct;78(4):337-42. doi: 10.1136/hrt.78.4.337. Heart. 1997. PMID: 9404246 Free PMC article.
-
A comparison of coronary angioplasty and coronary artery bypass grafting outcomes in chronic dialysis patients.Am J Kidney Dis. 1995 Feb;25(2):281-90. doi: 10.1016/0272-6386(95)90010-1. Am J Kidney Dis. 1995. PMID: 7847356
-
Prevention of restenosis after coronary balloon angioplasty: rationale and design of the Fluvastatin Angioplasty Restenosis (FLARE) Trial. The FLARE Study Group.Am J Cardiol. 1994 May 26;73(14):50D-61D. doi: 10.1016/0002-9149(94)90633-5. Am J Cardiol. 1994. PMID: 8198025 Clinical Trial.
-
[Balloon angioplasty of stent restenosis: early and late results of first and second PTCA in focal and diffuse stenosis].Z Kardiol. 1998;87 Suppl 3:65-71; discussion 79-80. doi: 10.1007/s003920050541. Z Kardiol. 1998. PMID: 9791913 Review. German.
-
Ischemia: reperfusion injury and restenosis after coronary angioplasty.Ann N Y Acad Sci. 1992 Sep 30;669:215-36. doi: 10.1111/j.1749-6632.1992.tb17102.x. Ann N Y Acad Sci. 1992. PMID: 1444028 Review.
Cited by
-
[Urgent or emergent coronary revascularization using bilateral internal thoracic artery after previous clopidogrel antiplatelet therapy].Z Kardiol. 2004 Sep;93(9):679-85. doi: 10.1007/s00392-004-0115-z. Z Kardiol. 2004. Retraction in: Clin Res Cardiol. 2013 Jan;102(1):91. doi: 10.1007/s00392-012-0526-1. PMID: 15365735 Retracted. German.
-
Coronary surgery in dialysis-dependent patients with end stage renal failure.Z Kardiol. 2005 Oct;94(10):679-83. doi: 10.1007/s00392-005-0286-2. Z Kardiol. 2005. PMID: 16200483
MeSH terms
LinkOut - more resources
Medical