Detection of restenosis after elective percutaneous transluminal coronary angioplasty using the exercise treadmill test.

Published

Journal Article

To determine the value of a 6-month exercise treadmill test for detecting restenosis after elective percutaneous transluminal coronary angioplasty (PTCA), 303 consecutive patients with successful PTCA and without a recent myocardial infarction were studied. Among the 228 patients without interval cardiac events, early repeat revascularization or contraindications to treadmill testing, 209 (92%) underwent follow-up angiography, and 200 also had a follow-up treadmill test and formed the study population. Restenosis (greater than or equal to 75% luminal diameter stenosis) occurred in 50 patients (25%). Five variables were individually associated with a higher risk of restenosis: recurrent angina (p = 0.0002), exercise-induced angina (p = 0.0001), a positive treadmill test (p = 0.008), more exercise ST deviation (p = 0.04) and a lower maximum exercise heart rate (p = 0.05). However, only exercise-induced angina (p = 0.002), recurrent angina (p = 0.01) and a positive treadmill test (p = 0.04) were independent predictors of restenosis. Using these 3 variables, patient subsets could be identified with restenosis rates ranging from 11 to 83%. The exercise treadmill test added independent information to symptom status about the risk of restenosis after elective PTCA. Nevertheless, 20% of patients with restenosis had neither recurrent angina nor exercise-induced ischemia at follow-up. For more accurate detection of restenosis, the exercise treadmill test must be supplemented by a more definitive test.

Full Text

Duke Authors

Cited Authors

  • Bengtson, JR; Mark, DB; Honan, MB; Rendall, DS; Hinohara, T; Stack, RS; Hlatky, MA; Califf, RM; Lee, KL; Pryor, DB

Published Date

  • January 1, 1990

Published In

Volume / Issue

  • 65 / 1

Start / End Page

  • 28 - 34

PubMed ID

  • 2294678

Pubmed Central ID

  • 2294678

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/0002-9149(90)90021-r

Language

  • eng

Conference Location

  • United States