Heart 1997;78:337-342 ( October )

Restenosis after elective coronary balloon angioplasty in patients with end stage renal disease: a case-control study using quantitative coronary angiography

Frank-Chris Schoebel,^a Frank Gradaus,^a Katrin Ivens,^b Peter Heering,^b Thomas Walter Jax,^a Bernd Grabensee,^b Bodo-Eckehard Strauer,^a Matthias Leschke^a

^a Medizinische Klinik und Poliklinik B, Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine Universität Düsseldorf, Moorenstrae 5, 40225 Düsseldorf, Germany, ^b Medizinische Klinik und Poliklinik F, Klinik für Nephrologie und Rheumatologie, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Germany

Correspondence to: Dr med Schoebel; email: Frank-Chris.Schoebel{at}uni-duesseldorf.de

Accepted for publication 4 July 1997

ObjectiveTo assess the rate of angiographic restenosis in patients with end stage renal disease after elective coronary angioplasty.
DesignA retrospective case-control study of 20 patients with end stage renal disease and 20 sex and age matched controls without renal disease, who had undergone primarily successful coronary angioplasty. Control coronary angiography was performed regardless of worsening or renewed incidence of anginal symptoms.
Main outcome measuresGroup comparison of coronary morphology, as evaluated by quantitative coronary angiography, and of cardiovascular risk factors.
ResultsThe rate of angiographic restenosis was 60% in patients with renal disease and 35% in controls. In patients with end stage renal disease the following differences (mean (SD) were found versus controls: raised plasma fibrinogen (483 (101) v 326 (62) mg/dl, p < 0.001); raised plasma triglyceride (269 (163) v 207 (176) mg/dl, p < 0.01); smaller diameter of the coronary reference segment (2.59 (0.87) v 2.90 (0.55) mm, p < 0.10); smaller minimum luminal diameter of the dilated stenosis (0.77 (0.46) v 0.97 (0.27) mm, p < 0.05). Discriminant analysis showed that minimum luminal diameter before angioplasty (r = 0.79) and fibrinogen (r = +0.34) had the highest statistical association with restenosis.
ConclusionsThe high rate of angiographic restenosis in patients with end stage renal disease seems to be related to the size of the vessel dilated and to an increased prothrombotic risk, as indicated by higher fibrinogen concentrations.

Keywords: renal disease;  coronary artery disease;  coronary angioplasty;  restenosis

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© 1997 by Heart
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