Impact of routine angiographic follow-up after angioplasty

Rupprecht, Hans‐Jürgen; Espinola‐Klein, Christine; Erbel, Raimund; Nafe, B.; Brennecke, R.; Dietz, Ulrich; Meyer, Jürgen

doi:10.1016/s0002-8703(98)70007-9

Cited by 37 publications

(22 citation statements)

References 28 publications

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“…28 -30 Routine 6-month follow-up angiography and resultant higher rates of repeat intervention may be related to a lower 10-year mortality rate. 7,31 The predictors of asymptomatic restenosis in the subgroup undergoing stent deployment were absence of the use of nitrates at 6-month follow-up and unstable angina at initial presentation. It is possible that stents may have a "plaquestabilizing" effect in the relief of symptoms in acute coronary syndromes (as opposed to stable angina).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

et al. 2001

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Background Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. Methods and Results All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariate analysis evaluated 46 clinical and angiographic variables, comparing those with and without angina. The 10 studies recruited 2690 patients who underwent percutaneous revascularization and 6-month follow-up angiography (86% of those eligible). Restenosis (≥50% diameter stenosis) occurred in 607 patients and was clinically silent in 335 (55%). Male sex ( P =0.008), absence of antianginal therapy with nitrates ( P =0.0002) and calcium channel blockers ( P =0.02) at 6 months, greater reference diameter after the procedure ( P =0.04), greater reference diameter at follow-up ( P =0.004), and lesser lesion severity (percent stenosis) at 6 months ( P =0.0004) were univariate predictors of asymptomatic restenosis. By multivariate analysis, only male sex ( P =0.04), greater reference diameter at follow-up ( P =0.002), and lesser lesion severity at 6 months ( P =0.0001) were associated with restenosis without angina. Conclusions Approximately half of patients with angiographic restenosis have no symptoms. The only multivariate predictors of silent restenosis at 6 months were male sex, greater reference diameter at follow-up, and lesser lesion severity on follow-up angiography.

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Section: Discussionmentioning

confidence: 99%

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

et al. 2001

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“…Es konnte gezeigt werden, daB Patienten, die routinem/~Big sechs Monate nach einer Koronarintervention -unabh~ingig vom Isch~imienachweis -nachangiographiert werden, eine signifikant niedrigere Sterblichkeit ira Verlauf der folgenden zehn Jahre aufweisen [12].…”

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Mengenzunahme diagnostischer und interventioneller Herzkatheter im krankenhausärztlichen und vertragsärztlichen Bereich in Deutschland

Silber

1999

Herz

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“…Die notwendigen Therapien ziehen wiederum einen erhöhten Kontrollbedarf nach sich, mit der Folge, dass sich die Leistungszahlen auf einem sehr hohen Niveau stabilisieren [5]. Routinemäßig durchgeführte Kontrollangiographien nach Koronarinterventionen waren nicht nur mit einer größeren Anzahl an Reinterventionen assoziiert, sondern auch mit einer signifikant niedrigeren Mortalität [6]. Des Weiteren kann die hohe Leistungsdichte auch eine Folge der hohen Angebotsdichte sein [7].…”

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The Impact of Social and Institutional Characteristics on the Appropriateness of Invasive Cardiologic Procedures

et al. 2006

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Social characteristics of patients and institutional characteristics have only a marginal impact on the indication of invasive cardiologic procedures. A trend toward "overdiagnostics" within the group of younger patients has been noticed, even in the case of missing hard medical evidence. A serious deficit of health care research can be found. Consented criteria to assess the appropriateness of medical treatments are missing. More research has to be done in the field of concepts and processes controlling the distribution and movement of patients into different sections of the health care system. Validated, standardized and comprehensive data for an international comparison of decisions about medical treatments are needed.

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Impact of routine angiographic follow-up after angioplasty

Cited by 37 publications

References 28 publications

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

Mengenzunahme diagnostischer und interventioneller Herzkatheter im krankenhausärztlichen und vertragsärztlichen Bereich in Deutschland

The Impact of Social and Institutional Characteristics on the Appropriateness of Invasive Cardiologic Procedures

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