In-stent restenosis (ISR) is a major limitation of coronary bare metal stent implantation. While investigational work in the field has mainly focused on the formation as well as putative predictors of ISR, little is known about the simultaneous progression of primarily untreated plaques in the coronary tree within the same patient. Without any interventional therapy, progression has been reported to occur in 7–20% of coronary plaques per year. Also, plaque progression apparently increases with severity of coronary artery disease as well as with patient anginal status.¹

In the present prospective study, we evaluated a patient cohort undergoing coronary stent implantation and six month re-angiogram to test whether progression in primarily untreated plaques would occur more frequently with target lesion ISR.

METHODS

In a prospective observational single centre registry, symptomatic patients undergoing first successful single stent implantation were enrolled between May 2001 and April 2002 at the Department of Cardiology, University of Bonn, Germany. Exclusion criteria were: angioplasty without stenting; presence of restenosis in the initial angiogram or previous coronary artery bypass grafting; multiple stent implantation in one lesion, or stenting in more than one lesion; significant left main coronary artery lesion; three vessel disease or chronic total occlusions; infection or inflammatory disease; …