BACKGROUND: In non-selected populations, coronary obstructions of small vessels are more likely to suffer restenosis after percutaneous interventions. Thus, the reference luminal diameter (RLD) is a particularly important angiographic parameter, which is inversely related to the restenosis rate. Additionally in non-selected patients, ultrasound (IVUS) studies have shown similar results regarding the influence of vascular dimensions as independent predictors of clinical restenosis. The aim of this study was to evaluate the angiographic and IVUS parameters as predictors of restenosis in patients submitted to PCI with stents in whom a high risk for restenosis was characterized in a prospective search for diabetes mellitus and dysglycemia METHODS: Seventy patients with 77 coronary artery obstructions were submitted to successful PCI with stents. Quantitative analysis of coronary angiograms and intracoronary ultrasonographic images were obtained immediately after and six months after the index procedure. An oral GTT test was performed in all patients without prior diagnosis of diabetes mellitus. RESULTS: Twenty-three diabetics (32.86%) and 16 patients with glucose intolerance (22.85%) were identified. The angiographic and IVUS parameters considered predictors of restenosis through bivariate analysis were: RLD > 2.82 mm six months after the procedure - RR=0.60 (0.15 - 0.81) 95% CI (p=0.014), Stent Volume < 119.8 mm³RR=0.74 (0.38 - 0.89) 95% CI (p=0.0005) and Stent Area < 8.91 mm² - RR=0.66 (0.24 - 0.85) 95% CI (p=0.006). By logistic regression multivariate analysis, stent volume mm³ < 119.8 was considered the only independent predictor of coronary restenosis (p=0.01). CONCLUSIONS: In this population with high risk for coronary restenosis, vessel dimensions were inversely related to its occurrence. A stent volume < 119.8mm³ measured by IVUS was the only independent predictor of restenosis after PCI.
Angioplasty, transluminal, percutaneous coronary; Coronary restenosis; Ultrasonography, interventional; Diabetes mellitus
