Effect of Homocysteine-Lowering therapy on restenosis after percutaneous coronary intervention for narrowings in small coronary arteries

Abstract

umenting all balloon infl ations on fi lm. To that end, investigators were provided a protocol for acquiring angiograms at the initiation of the trial to ensure optimal angiographic quality. Although compliance with the protocol and fi lm quality were generally excellent, deviations from the protocol were not quantifi ed, and some device use may not have been captured on fi lm. Second, the high frequency of geographic miss in our study, based on our defi nition, may limit our ability to detect differences between the groups because of the small sample of patients without geographic miss. Finally, intravascular ultrasound was not performed systematically at follow-up, but would have provided valuable insight into the mechanism of edge recurrence. In INHIBIT, the presence and length of geographic miss were not associated with increases in overall restenosis for either radiated or placebo patients. The treatment effect of P-32 was maintained despite the presence of geographic miss, and there was no identifiable detrimental interaction between radiation and geographic miss. There is no angiographic evidence that P-32 has a proliferative effect as the dose decreases. 1. Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, Pichard AD, Kent KM, Stone GW, Leon MB. Angiographic patterns of in-stent restenosis: classifi cation and implications for long-term outcome. Circulation 1999;100: 1872–1878.