Value of lesion morphology and of residual stenosis in predicting late clinical outcomes and restenosis rate post-PTCA in single-vessel disease

Abstract

The study assessed an impact of stenosis morphology before coronary angioplasty (PTCA) and of residual diameter stenosis after the procedure on major adverse cardiac events and restenosis rate at 1 year after intervention in single-vessel disease. Visual analysis of stenoses, using the ABC lesion score system and on-line quantitative evaluation (ACA, DCI, Philips), was performed in 70 patients undergoing PTCA. Recurrence of angina at rest and/or positive treadmill exercise test (TET) ≥6 weeks after PTCA and/or major cardiac events were considered as evidence of restenosis. At 1 year follow-up 56 patients (80%) were event free, without angina at rest and without positive TET, with residual diameter (RD) after PTCA a mean of 2.00 ± 0.48 mm. In the restenosis group (n = 14) RD was a mean of 1.58 ± 0.43 mm (p <0.01): there were three patients with angina at rest, five with Positive TET, and six with cardiac events. In this group, one-half of the stenoses was in class C of the lesion. Residual diameter stenosis, measured objectively after balloon angioplasty, and evaluation of lesion morphology before PTCA can predict late clinical outcomes after the procedure in single-vessel disease.