Author + information
- Received February 15, 1995
- Revision received January 17, 1996
- Accepted January 23, 1996
- Published online June 1, 1996.
- Izuru Nakae, MDa,
- Masatoshi Fujita, MD∗∗,
- Tetsuro Fudo, MDa,
- Tomoyuki Iwase, MDa,
- Terumitsu Tanaka, MDa,
- Shun-Ichi Tamaki, MDa,
- Ryuji Nohara, MD∗ and
- Shigetake Sasayama, MD,FACC∗
- ↵∗Address for correspondenceDr. Masatoshi Fujita, College of Medical Technology, Kyoto University, 53 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-01, Japan.
Objectives.The purpose of this study was to test the hypothesis that the incidence of restenosis after primary percutaneous transluminal coronary angioplasty for acute myocardial infarction is largely influenced by the preexistent coronary collateral circulation to the infarct-related coronary artery.
Background.The occurrence of restenosis after coronary angioplasty is the most limitation of this procedure. However, prediction of restenosis is difficult. Severe preexistent stenosis of the infarct-related coronary artery causing the development of collateral circulation may result in a high frequency of restenosis.
Methods.The study group consisted of 152 consecutive patients undergoing primary coronary angioplasty within 12 h after the onset of a first acute myocardial infarction. Of this group, 124 patients were angiographically followed up during the convalescent period of infarction and were classified into two groups according to the extent of preexistent collateral circulation to the infarct-related coronary artery.
Results.Restenosis occurred in 26 (38%) of 69 patients with poor or no collateral circulation (group A) in contrast to 35 (64%) of 55 patients with good angiographic collateral circulation (group B, p < 0.005). The frequency of preinfarction angina was significantly lower (p < 0.05) in group A (26% [18 of 60]) than in group B (44% [24 of 55]).
Conclusions.These findings indicate that the presence of well developed collateral circulation to the infarct-related coronary artery predicts a higher frequency of restenosis after primary coronary angioplasty. The difference in restenosis rates observed between the patients with and without good collateral circulation probably reflects the impact of underlying severity of stenosis on the long-term outcome after coronary angioplasty.
☆ This work was supported by Grant-in-Aid for Scientific Research (c) 07670777 from the Ministry of Education, Science and Culture, Tokyo, Japan.
- Received February 15, 1995.
- Revision received January 17, 1996.
- Accepted January 23, 1996.