Clinical and Angiographic Predictors of Coronary Stent Restenosis

Seo, Jeong Pyeong; Jeong, Myung Ho; Kang, Kyung Tae; Park, Hyung Wook; Kim, Joon Woo; Kim, Sung Hee; Cho, Jang Hyun; Lee, Soong; Yang, Seung Won; Jang, An Soo; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

Abstract

Coronary stent has been knowm as one of effective new devices for the prevention of acute arterial occlusion by intimal dissection and late restenosis after coronary angioplasty. However, stent restenosis remains a major limitation of clinical coronary stenting. This study was aimed to identify clinical, angiographic and procedural characteristics, which may be related to coronary stent restenosis.Follow-up coronary angiograms were performed in 206 patients (163 male, 43 female, 57+/-9.2 year) out of 583 patients, who underwent coronary stenting between Aug '92 to Jun '98 in Chonnam University Hospital. Clinical diagnoses were 68 acute myocardial infraction (33%), 17 old myocardial infraction (8%), 80 unstable angina (39%) and 41 stable angina (23%). Target coronary arteries were 134 left anterior descending arteries (62%), 52 right coronary arteries (24%), 31 left circumflex arteries (14%) and 1 left main coronary artery. The follow-up angiograms were obtained at 6.4+/-4.2 months and variables of patients with stent restenosis were compared with those of patients without restenosis.Overall coronary stent restenosis rate was 33.3%. Clinical and angiographic variables of age, sex, atherosclerosis risk factors, clinical diagnosis, lesion types, stent types, indications for stent, ballon diameter and inflation pressure, reference vessel diameter and stenosis severity were not predictive of coronary stent restenosis. Restenosis rate of longer stent > or =20 mm was 41.7%, in those late luminal loss was 1.40+/-0.72 mm, which were higher than those of shorter stent <20 mm (22.2% and 1.05+/-0.72 mm, p<0.05 respectively). Restenosis rate was 50.5% in the vessels with minimum luminal diameter (MLD)<2.2 mm, which was higher than in the vessels of 2.3-3.4 mm of MLD (34.0%) and in MLD>3.5 mm (10.0%, p<0.03 respectively), Stent restenosis rate was 61.0% in the vessels with residual stenosis (RS)> or =20%, whcih was higher than 28.3% in those with RS<20% (p<0.01). Coronary stent longer than 20 mm, small luminal diameter less 2.2 mm, and residual stenosis more than 20% after stent are good predictors of stent restenosis.