Factors affecting the restenosis rate after percutaneous transluminal coronary angioplasty

In an open study follow-up angiographies were performed independently from the clinical course on altogether 131 consecutive patients (99 men, 32 women) six months after percutaneous transluminal coronary angioplasty (PTCA). During this period patients received at least 320 mg of aspirin daily. Possible factors affecting the restenosis rate included age, sex, diabetes mellitus, arterial hypertension, abnormal lipid metabolism, smoking, dosage of aspirin administered, degree of stenosis shown by affected vessels before dilatation, number of vascular segments dilated and platelet reactivity. Restenosis was defined as a renewed narrowing of the dilated segment by 50% or more, with an increase in stenosis by at least 20%. In the present study the following restenosis rates were found six month after a primarily successful PTCA: 30% for the entire sample (39 out of 131 patients); 25% in patients with normal platelet function, 50% in those with mildly abnormal platelet function, and 60% in those with frankly abnormal platelet function; 24% in non-diabetic patients and 45% in diabetics. Analysis of the findings showed that abnormal platelet function and the presence of diabetes mellitus were the most important factors in the subsequent development of restenosis after angioplasty. The same also applied in a more restricted manner to the degree of stenosis present before angioplasty.