INTERVENTIONAL CARDIOLOGY AND SURGERY

Serial six year quantitative angiographic follow up in asymptomatic patients following successful coronary angioplasty

Y Takeda¹, T Kobayashi¹, N Awata¹, S Sato², J H C Reiber³, T Nakagawa⁴, E Tsuchikane¹, O Katoh¹, M Kirino¹, T Kobayashi¹, K Yachiku¹, N Shibata¹

¹ Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
² Osaka Medical Centre for Health Science and Promotion, Osaka, Japan
³ Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands
⁴ Toyonaka Municipal Hospital, Osaka, Japan

Correspondence to:
Correspondence to:
Dr Y Takeda
Department of Cardiology, Osaka Medical Centre for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinariku, Osaka City, Osaka 537-8511, Japan; takeda{at}xk9.so-net.ne.jp

Objective: To evaluate long term (six years) lumen changes after balloon angioplasty by using quantitative coronary angiography.

Methods: Complete serial quantitative coronary angiography (before and after angioplasty and at six months, three years, and six years) was performed in 100 patients with successful angioplasty and without subsequent repeated revascularisation. In all, 198 dilated segments were compared with 395 non-dilated segments that were obtained from non-target arteries of study patients.

Results: From six months to three years after angioplasty, minimum lumen diameter (MLD) increased significantly by 0.13 (0.28) (mean (SD)) mm in dilated segments and decreased significantly by 0.04 (0.27) mm in non-dilated segments. From three years to six years, MLD remained stable in dilated segments but decreased further (by 0.04 (0.28) mm) in non-dilated segments. Consequently, the MLD between six months and six years was larger in dilated segments than in non-dilated segments (0.12 (0.32) v –0.08 (0.34); p < 0.001). Further, MLD from six months to six years correlated positively with the percentage diameter stenosis (DS) at six months in each group (dilated segments r = 0.47, p < 0.0001; non-dilated segments r = 0.49, p < 0.0001). Multivariate analysis showed that the only independent predictor of MLD over six years for each group was the DS at six months.

Conclusions: Lesion regression occurs within the first three years after angioplasty and reaches a plateau thereafter. Moreover, the stenosis severity at six months predicts the magnitude of late regression after angioplasty.

Abbreviations: DS, percentage diameter stenosis; MLD, minimum lumen diameter; PCS, prevention of coronary sclerosis; QCA, quantitative coronary angiography

Keywords: coronary angioplasty; regression

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