Repeat angioplasty tied to more heart problems

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Patients who’ve already undergone angioplasty to open a blocked heart vessel and have to have a repeat angioplasty are at increased risk for problems such as death or heart attack, researchers report.

Patients who’ve already undergone angioplasty to open a blocked heart vessel and have to have a repeat angioplasty are at increased risk for problems such as death or heart attack, researchers report in the American Journal of Cardiology.

Because patients with a prior angioplasty are often excluded from clinical trials, little information is available on the long-term outcome of repeat angioplasty, senior researcher Dr. Sheldon Goldberg of Hahnemann University, Philadelphia, and colleagues note.

To investigate further, the researchers used data from patients who underwent angioplasty while taking part in a drug study. In all, 7,065 subjects had not had a previous angioplasty, 1,281 had had a previous angioplasty of the blockage now being targeted and 1,408 had had a previous angioplasty of a different blockage.

At one month after angioplasty, there were no significant differences between the groups in the rate of major adverse heart events, including death, heart attack and the need for further operations.

However, by nine months, 34 percent of patients who underwent angioplasty again for the same blockage had experienced an adverse event compared with 19 percent of patients with no prior angioplasty. For patients with previous angioplasty of a different blockage, the corresponding proportion was 24 percent.

These findings have “reconfirmed the need for the development and trial of new methods to improve the outcomes of” patients undergoing repeat angioplasty.

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