Predictive factors of restenosis after stenting in proximal left anterior descending coronary artery

Lee, Seung Hyun; Jeong, Myung Ho; Sim, Doo Sun; Lee, Sang Hyun; Hong, Young Joon; Park, Ok Young; Park, Woo Seok; Kim, Ju Han; Kim, In Soo; Choi, Myung Ja; Kim, Weon; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

Abstract

BACKGROUND: A proximal Left anterior descending coronary artery (LAD) is one of the most important arterial segment due to its wide area of myocardial blood supply and high incidence of restenosis after percutaneous coronary intervention. This study was aimed to predict the risk factor after stenting in proximal LAD.
METHODS
A total of 412 patients with proximal LAD stent implantation, who underwent follow-up coronary angiogram except for the LAD ostial lesion between 1996 and 2001 at Chonnam National University Hospital, were divided into two groups: Restenosis group (n=144 : 57.5 +/- 10.2 years, 78.8% male) and no restenosis group (n=268 : 57.4 +/- 10.0 years, 76.8% male). Restenosis rate, complications and predictive factors after proximal LAD stenting were analyzed.
RESULTS
There were no differences in baseline clinical characteristics of sex, age, risk factors of atherosclerosis, lipid profile, clinical diagnosis, type and number of lesion coronary artery, Thrombolysis In Myocardial Infarction flow between the two groups. The restenosis rate after proximal LAD stenting was 35.0%. The complications during the follow up period after stenting were one transient ischemic attack in restesnosis group and one non-hemorrhagic stroke in both groups. There were no differences in major advanced cardiac event until the 12th month clinical follow up. There were no differences in lesion length, reference diameter, minimal luminal diameter, diameter stenosis and stent diameter, but the stent length were longer (20.7 +/- 6.92 mm) in restenosis group compared with no restenosis group (18.8 +/- 6.18 mm, p=0.006).
CONCLUSION
The restenosis rate after proximal LAD stenting is relatively high and the only predictive factor for restenosis is stent length.