eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
4/2020
vol. 16
 
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abstract:
Original paper

The risk for subsequent coronary interventions in a local Polish population

Jaroslaw Hiczkiewicz
1, 2
,
Paweł Burchardt
3, 4
,
Konrad Pieszko
1, 2
,
Jan Budzianowski
1, 2
,
Dariusz Hiczkiewicz
1, 2
,
Bogdan Musielak
1, 2
,
Anna Winnicka-Zielinska
1, 2
,
Daria Adamczak
5

1.
Department of Cardiology, Multidisciplinary District Hospital, Nowa Sol, Poland
2.
Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
3.
Department of Hypertension, Angiology, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
4.
Department of Cardiology, J. Strus Hospital, Poznan, Poland
5.
Ist Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
Adv Interv Cardiol 2020; 16, 4 (62): 429–435
Online publish date: 2021/01/05
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Introduction
Paradoxically, the literature lacks an assessment of the impact of various factors on subsequent coronary interventions in patients with coronary artery disease (CAD). Aim: To assess the impact of various factors on subsequent percutaneous transluminal coronary angioplasty (PTCA), as well as to characterize the clinical profile of people undergoing repeated diagnostic coronary angiography without significant coronary artery changes.

Material and methods
We investigated retrospective data from 4041 subjects according to the clinical factors which may affect the occurrence of unplanned future PTCA.

Results
The strongest risk factors for subsequent PTCA were significant stenosis of left descending artery (OR = 2.17, 95% CI: 1.09–4.32) during baseline coronary angiography, the atherosclerotic burden (number of critically narrowed vessels) (OR for narrowing lesions in 3 epicardial arteries 12.13, 95% CI: 5.40–27.27), and restenosis in a previously implanted stent (OR = 4.34, 95% CI: 1.96–9.62). A strong positive relationship between total mortality and the number of critically narrowed coronary arteries (during baseline hospitalization) was observed. Patients without significant coronary artery stenosis in two diagnostic angiographies (control group) differed from subjects with hemodynamic relevant CAD in: higher creatinine levels, more frequent presence of chronic obstructive pulmonary disease and more frequent symptoms of intermittent claudication.

Conclusions
The results of the study are in accord with real clinical practice. The arteriosclerotic burden is a major cause of recurrent PTCA, but an important clinical issue is the qualification for recurrent coronary-angiography in those patients whose previous coronary angiography did not show significant stenosis, because other clinical causes may explain their symptoms.

keywords:

subsequent percutaneous transluminal coronary angioplasty, coronary artery disease, ischemic heart disease

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