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Restenosis After Angioplasty in Patients with Left Ventricular Dysfunction

University Hospital of Homburg Saar Homburg, Germany

For reprint information contact: Ahmed Magdy, MD Tel: 966 3 820 0000 Fax: 966 3 820 3436 Al Mouawasat Hospital, P. O. Box 282, Dammam 31411, Saudi Arabia.

Clinical and angiographic rates of restenosis after angioplasty were compared in 80 patients (group A) with ejection fractions below 40% (mean, 28.3% ± 5.2%) and 50 (group B) with ejection fractions above 50% (mean, 58% ± 5.4%). Mean angina class improved to the same degree in both groups after angioplasty. Recurrence of significant angina within 6 to 12 months affected 30 patients (38%) in group A compared to 12 (24%) in group B (p > 0.05). Angiographic restenosis occurred in 42 patients (53%) in group A compared to 14 (28%) in group B (p = 0.006). Restenosis after single-vessel angioplasty was 46% in group A and 25% in group B (p > 0.05), after multivessel angioplasty it was 62% in group A and 33% in group B (p = 0.05). In group A, restenosis was more frequent in the left anterior descending coronary artery (46%) compared to the right coronary (41%) or circumflex (30%). Higher rates of restenosis occurred in patients with prior coronary artery bypass grafting (64%) or recanalization of chronic total occlusion (61%). Angina was a less reliable indication of restenosis in group A. We attribute the higher rate of restenosis in patients with low ejection fractions partly to low coronary perfusion pressure.