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Restenosis after coronary stenting predicted 4-year mortality
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Restenosis detected by angiography independently predicted 4-year mortality in a large cohort of patients undergoing coronary stenting, recent findings concluded.
Despite evidence that routine control angiography is associated with high sensitivity in detecting restenosis after coronary stenting, controversy surrounds the prognostic role of restenosis.
In the current study, investigators aimed to determine 4-year survival outcomes in a cohort of 10,004 patients (15,004 treated lesions) undergoing routine control angiography in the setting of coronary stenting.
Eligible participants included all individuals who underwent successful coronary stenting for de novo lesions between 1998 and 2009 in Germany. The cohort also included individuals who underwent routine control angiography after 6 to 8 months at two centers in Munich.
Clinicians defined restenosis as diameter stenosis ≥50% in the in-segment area when angiography was conducted at follow-up.
Results indicated a restenosis rate of 26.4%. The researchers reported that 702 deaths occurred during the follow-up period. Restenosis was found in 218 of the patients who died, while no restenosis was reported for 484 deaths (unadjusted HR=1.19; 95% CI, 1.02-1.40).
Multivariate analysis results showed that restenosis independently predicted 4-year mortality (HR=1.23; 95% CI, 1.03-1.46).
Each 10-year increase in age (HR=2.34; 95% CI, 2.12-2.60), diabetes (HR=1.68; 95% CI, 1.41-1.99), current smoking habit (HR=1.39; 95% CI, 1.09-1.76) and each 5% decrease in left ventricular ejection fraction (HR=1.39; 95% CI, 1.31-1.48) also independently predicted 4-year mortality.
“In this large cohort of patients, the presence of restenosis at follow-up angiography after coronary stenting was predictive of 4-year mortality,” the researchers concluded. “Whether routine control angiography after coronary stenting is beneficial and influences outcomes should be evaluated by properly designed randomized trials.”
Disclosure: The researchers report financial disclosures with Abbott, B. Braun, Biosensors and Biotronik.
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