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5. Patient-related variables and restenosis after percutaneous transluminal coronary angioplasty: a report from the M-HEART (Multi-Hospital Eastern Atlantic Restenosis Trial) Group

Author

Macdonald, Robert G., Henderson, Mark A., Hirshfeld, John W., Jr., Goldberg, Sheldon H., Bass, Theodore, Vetrovec, George, Cowley, Michael, Taussig, Andrew, Whitworth, Hall, Margolis, James R., Hill, James A., Jugo, Ralph, and Pepine, Carl J.

Subjects
Coronary heart disease -- Prognosis, Coronary arteries -- Dilatation, Coronary arteries -- Obstruction, Transluminal angioplasty -- Complications, Health
Abstract

Coronary artery disease (CAD) is a condition in which the coronary arteries supplying blood to the heart become narrow (stenosed) or occluded, causing a decrease in cardiac blood flow and oxygenation (myocardial ischemia). One treatment for CAD, percutaneous transluminal coronary angioplasty (PTCA), involves the introduction of a balloon-tipped catheter into an affected coronary artery and mechanically widening the blocked region by inflating the balloon, and thereby reestablishing blood flow to the oxygen-deprived region of the heart. Rates of restenosis are relatively high in the months following PTCA; between 17 and 47 percent of patients show some evidence of restenosis at 6-month follow-up. A number of variables have been implicated in the development of restenosis. In order to study the quantitative relationship between a wide range of patient variables and the occurrence of restenosis, 722 patients who had undergone successful PTCA were classified on the basis of various risk factors, and given a follow-up examination six months after PTCA. Restenosis was detected in 40 percent of the patients in whom follow-up examinations could be performed (71 percent of the original group). Predictably, restenosis rates were higher in patients who were reevaluated at an earlier date as the result of a cardiovascular emergency, compared with patients who reported at the scheduled six-month exam. None of the risk factors on which data were gathered (smoking status, age, sex, presence of diabetes mellitus, history of previous heart attack, or duration and severity of chest pains) provided any indication of the likelihood of a patient's developing restenosis. The decision to perform PTCA on individual patients should not be influenced by these variables. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

9. Spontaneous coronary artery dissection

Author

Khan, Nazim Uddin Azam, primary, Miller, Michael J., additional, Babb, Joseph D., additional, Ahmed, Sagir, additional, Saha, Pabitra K., additional, Shammas, Rony L., additional, Macdonald, Robert G., additional, and Movahed, Assad, additional

Published
2006
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10. Left main coronary artery disease progression after percutaneous transluminal coronary angioplasty

Author

Kells, Catherine M., Miller, Robert M., Henderson, Mark A., Lomnicki, Judy M., and Macdonald, Robert G.

Subjects
Transluminal angioplasty -- Evaluation, Coronary heart disease -- Causes of, Health
Abstract

A common procedure for treating disease of the coronary arteries, which deliver blood to the heart muscle itself, is percutaneous transluminal coronary angioplasty (PTCA). This approach uses a small balloon which is inserted into a large vein under X-ray guidance, threaded into the heart, then inflated to enlarge the diameter of a constricted coronary artery. Reports of new or recurrent disease in the left main coronary artery (LMCA) after PTCA of this artery or others close to it, however, have appeared in the medical literature. It is important to know whether this is a consequence of the procedure itself. Six months after an initial PTCA, patients received a follow-up angiographic examination, the X-ray procedure used to evaluate the health of coronary arteries. The diameter of LMCA segments was measured on angiograms from the two examinations and compared to see whether change had occurred in the blood vessel's diameter. Angiograms from almost 300 patients were compared in this manner. Patients who underwent PTCA in the left coronary artery system made up Group I, while those having PTCA in other arteries or in bypass grafts made up Group II. The overall rate of disease progression in the LMCA was 1.3 percent of patients, with no statistically significant difference between the two groups. Comparison of disease rates after PTCA of the LMCA and of other arteries showed no difference, but since the small number of patients who did develop disease were all from Group 1, a study using more patients could find an effect. The data do suggest that patients with LMCA stenosis before the procedure may be at higher risk from PTCA than those without disease of this artery (17 percent as compared with 0 percent). On the whole, though, PTCA carries with it a very low risk of coronary artery disease developing as a result of the procedure itself. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

11. Effect of Thromboxane A 2 Blockade on Clinical Outcome and Restenosis After Successful Coronary Angioplasty

Author

Savage, Michael P., primary, Goldberg, Sheldon, additional, Bove, Alfred A., additional, Deutsch, Ezra, additional, Vetrovec, George, additional, Macdonald, Robert G., additional, Bass, Theodore, additional, Margolis, James R., additional, Whitworth, Hall B., additional, Taussig, Andrew, additional, Hirshfeld, John W., additional, Cowley, Michael, additional, Hill, James A., additional, Marks, Ronald G., additional, Fischman, David L., additional, Handberg, Eileen, additional, Herrmann, Howard, additional, and Pepine, Carl J., additional

Published
1995
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15. Multi-Hospital Eastern Atlantic Restenosis Trial II: A placebo-controlled trial of thromboxane blockade in the prevention of restenosis following coronary angioplasty

Author

Savage, Michael P., primary, Goldberg, Sheldon, additional, Macdonald, Robert G., additional, Bass, Theodore A., additional, Margolis, James R., additional, Whitworth, Hall B., additional, Taussig, Andrew S., additional, Vetrovec, George, additional, Cowley, Michael, additional, Bove, Alfred A., additional, Kleaveland, Patrick, additional, Hirshfeld, John W., additional, Hill, James A., additional, Gilmore, Paul, additional, and Pepine, Carl J., additional

Published
1991
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16. Restenosis after coronary angioplasty: A multilvariate statistical model to relate lesion and procedure variables to restenosis

Author

Hirshfeld, John W., primary, Schwartz, J.Sanford, additional, Jugo, Ralph, additional, Macdonald, Robert G., additional, Goldberg, Sheldon, additional, Savage, Michael P., additional, Bass, Theodore A., additional, Vetrovec, George, additional, Cowley, Michael, additional, Taussig, Andrew S., additional, Whitworth, Hall B., additional, Margolis, James R., additional, Hill, James A., additional, and Pepine, Carl J., additional

Published
1991
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17. Clinical and angiographic determinants of primary coronary angioplasty success

Author

Savage, Michael P., primary, Goldberg, Sheldon, additional, Hirshfeld, John W., additional, Bass, Theodore A., additional, MacDonald, Robert G., additional, Margolis, James R., additional, Taussig, Andrew S., additional, Vetrovec, George, additional, Whitworth, Hall B., additional, Zalewski, Andrew, additional, Hill, James A., additional, Cowley, Michael, additional, Jugo, Ralph, additional, and Pepine, Carl J., additional

Published
1991
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18. Patient-related variables and restenosis after percutaneous transluminal coronary angioplasty — A report from the M-HEART Groupt

Author

Macdonald, Robert G., primary, Henderson, Mark A., additional, Hirshfeld, John W., additional, Goldberg, Sheldon H., additional, Bass, Theodore, additional, Vetrovec, George, additional, Cowley, Michael, additional, Taussig, Andrew, additional, Whitworth, Hall, additional, Margolis, James R., additional, Hill, James A., additional, Jugo, Ralph, additional, and Pepine, Carl J., additional

Published
1990
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19. Multi‐hospital Eastern Atlantic Restenosis trial: Design, recruitment, and feasibility

Author

Hill, James A., primary, Macdonald, Robert G., additional, Jugo, Ralph, additional, Hirshfeld, John W., additional, Goldberg, Sheldon, additional, Savage, Michael P., additional, Vetrovec, George, additional, Cowley, Michael, additional, Bass, Theodore A., additional, Margolis, James R., additional, Whitworth, Hall B., additional, Taussig, Andrew S., additional, Bove, Alfred A., additional, and Pepine, Carl J., additional

Published
1990
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