経皮的冠動脈形成術(PTCA)の再狭窄に関する研究 : 第1報 PTCAの適応病態と再狭窄との関係

概要

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To elucidate the relationship between clinical condition prior to percutaneous transluminal coronary angioplasty (PTCA) and clinical restenosis, defined as recurrence of symptoms with > 50% stenosis at the PTCA site, we studied retrospectively 368 consecutive patients with angina who had undergone their first successful single-lesion PTCA. Patients were divided into 4 groups according to their prevailing clinical condition prior to PTCA: stable angina (SA), 159 patients; unstable angina (UA), 116 patients; post-infarction angina (PIA), 48 patietns; and refractory angina (RA) requiring emergency PTCA, 45 patients. Patients with RA had more complex lesions (RA: 75%, SA: 41%, UA: 43%, PIA: 60%, p<0.01), a higher angiographic and clinical restenosis rate (62, 30, 46, 45%, p<0.01; 41, 21, 31, 18%, p<0.05, respectively) and a higher incidence of cardiac events due to restenosis (47, 18, 30, 34%, p<0.01). The pattern of angina at restenosis was severe (severe angina with or without myocardial infarction requiring emergency admission) in the RA group (RA: 86%, SA: 41%, UA: 42%, PIA: 43%, p<0.01). These results indicate that emergency PTCA for refractory angina has limitations due to the high incidence of restenosis and accompanying cardiac events, in addition to the severe pattern of clinical angina when restenosis occurs. Close post-PTCA surveillance is necessary in these patients.
東京女子医科大学の論文
1996-11-25