학술논문
Risk factors for progression of atherosclerosis six months after balloon angioplasty of coronary stenosis
Document Type
Periodical
Author
Source
American Journal of Cardiology. April 15, 1990, Vol. 65 Issue 15, p980, 6 p.
Subject
Language
ISSN
0002-9149
Abstract
To assess the Possible Progression of coronary artery disease after percutaneous transluminal coronary angloplasty (PTCA) and its relation to risk factors and restenosis, 124 patients who under. went a first successful PTCA were studied. All had routine follow-up angiography 5 to 8 months after PTCA. Restenosis was defined as a 30% decrease in diameter stenosis or a return to >50% stenosis, and progression (in any nondilated site) as a 20% decrease in diameter stenosis, assessed by a video densitometric computer-assisted technique. Univariate and multivariate analysis with respect to progression was carried out for age, sex, initial unstable angina, previous myocardial infarction, diabetes mellitus, hypertension, hypercholesterolemia >6.2 mmol), smoking habits, Jenkins' score, dilated artery and restenosis. Forty-one patients (33%) had restenosis, and 23 (19%) had evidence of progression; 20 (87%) of these latter patients had restenosis and 3 (13%) did not. Univariate correlates of progression were: previous myocardial infarction (p (Am J Cardiol 1990;6S:980-985)
Acute myocardial infarction, or heart attack, is an often fatal event resulting from a blockage of one of the coronary arteries, supplying blood to the heart. This blockage may be due to the presence of fatty deposits, as occurs in atherosclerosis, or blood clots. Percutaneous transluminal coronary angioplasty (PTCA) is a procedure in which a small balloon is positioned in the blocked artery and then inflated. This action compresses the fatty deposit against the coronary arterial wall and results in a restoration of blood flow. The compression of the fatty deposit causes a local reaction on the arterial wall that increases the muscle content and eventually leads to blockage or re-occlusion of the vessel. Since an increase in arterial wall muscle content also produces the occlusion seen in atherosclerosis, a common mechanism may be shared in both cases. A recent study of 124 PTCA-treated patients examined the rate of re-occlusion in treated vessels and the progression of atherosclerosis in non-treated vessels. All patients had X-rays of their coronary arteries five to eight months after PTCA treatment. Thirty-three percent of the patients had evidence of vessel re-occlusion and 20 percent had progression of their atherosclerosis. Eighty-seven percent of the patients with progression of atherosclerosis later developed vessel re-occlusion. Risk factors associated with the progression of atherosclerosis include a high cholesterol count, diabetes mellitus, elevated blood pressure, and a history of a previous myocardial infarction. This study indicates that re-occlusion of PTCA-treated vessels may be related to the progression of atherosclerosis, but further studies are needed before definite conclusions may be made. (Consumer Summary produced by Reliance Medical Information, Inc.)
Acute myocardial infarction, or heart attack, is an often fatal event resulting from a blockage of one of the coronary arteries, supplying blood to the heart. This blockage may be due to the presence of fatty deposits, as occurs in atherosclerosis, or blood clots. Percutaneous transluminal coronary angioplasty (PTCA) is a procedure in which a small balloon is positioned in the blocked artery and then inflated. This action compresses the fatty deposit against the coronary arterial wall and results in a restoration of blood flow. The compression of the fatty deposit causes a local reaction on the arterial wall that increases the muscle content and eventually leads to blockage or re-occlusion of the vessel. Since an increase in arterial wall muscle content also produces the occlusion seen in atherosclerosis, a common mechanism may be shared in both cases. A recent study of 124 PTCA-treated patients examined the rate of re-occlusion in treated vessels and the progression of atherosclerosis in non-treated vessels. All patients had X-rays of their coronary arteries five to eight months after PTCA treatment. Thirty-three percent of the patients had evidence of vessel re-occlusion and 20 percent had progression of their atherosclerosis. Eighty-seven percent of the patients with progression of atherosclerosis later developed vessel re-occlusion. Risk factors associated with the progression of atherosclerosis include a high cholesterol count, diabetes mellitus, elevated blood pressure, and a history of a previous myocardial infarction. This study indicates that re-occlusion of PTCA-treated vessels may be related to the progression of atherosclerosis, but further studies are needed before definite conclusions may be made. (Consumer Summary produced by Reliance Medical Information, Inc.)