Restenosis after elective coronary balloon angioplasty in patients with end stage renal disease: a case-control study using quantitative coronary angiography

• Published in: Heart (British Cardiac Society) Vol. 78; no. 4; pp. 337 - 342
• Main Authors: Schoebel, Frank-Chris, Gradaus, Frank, Ivens, Katrin, Heering, Peter, Jax, Thomas Walter, Grabensee, Bernd, Strauer, Bodo-Eckehard, Leschke, Matthias
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.10.1997; BMJ; BMJ Publishing Group LTD
• Subjects: Angioplasty; Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Case-Control Studies; Cholesterol; Cholesterol - blood; Cholesterol, HDL - blood; Coronary Angiography; coronary angioplasty; coronary artery disease; Coronary Disease - complications; Coronary Disease - diagnostic imaging; Coronary Disease - therapy; Coronary heart disease; Coronary vessels; Discriminant analysis; Fibrinogen - metabolism; Heart; Heart attacks; Humans; Intervention; Kidney diseases; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - diagnostic imaging; Male; Medical imaging; Medical sciences; Middle Aged; Morphology; Mortality; Population; Recurrence; renal disease; restenosis; Retrospective Studies; Risk factors; Stents; Thrombosis; Triglycerides - blood; Germany; Kidney disease; Human; Postoperative; Urinary system disease; Radiodiagnosis; Angiography; Coronary artery; Instrumentation therapy; Cardiovascular disease; Instrumental dilatation; Case control study; Coronary heart disease; Terminal; Restenosis; Renal failure; Complication; Quantitative analysis
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.78.4.337

Objective To assess the rate of angiographic restenosis in patients with end stage renal disease after elective coronary angioplasty. Design A retrospective case-control study of 20 patients with end stage renal disease and 20 sex and age matched controls without renal disease, who had undergone primarily successful coronary angioplasty. Control coronary angiography was performed regardless of worsening or renewed incidence of anginal symptoms. Main outcome measures Group comparison of coronary morphology, as evaluated by quantitative coronary angiography, and of cardiovascular risk factors. Results The rate of angiographic restenosis was 60% in patients with renal disease and 35% in controls. In patients with end stage renal disease the following differences (mean (SD) were found versus controls: raised plasma fibrinogen (483 (101)v 326 (62) mg/dl, p < 0.001); raised plasma triglyceride (269 (163) v 207 (176) mg/dl, p < 0.01); smaller diameter of the coronary reference segment (2.59 (0.87) v 2.90 (0.55) mm, p < 0.10); smaller minimum luminal diameter of the dilated stenosis (0.77 (0.46)v 0.97 (0.27) mm, p < 0.05). Discriminant analysis showed that minimum luminal diameter before angioplasty (r = −0.79) and fibrinogen (r = +0.34) had the highest statistical association with restenosis. Conclusions The high rate of angiographic restenosis in patients with end stage renal disease seems to be related to the size of the vessel dilated and to an increased prothrombotic risk, as indicated by higher fibrinogen concentrations.