ORIGINAL ARTICLE
The influence of coronary heart disease risk factors and alcohol abstinence on stenocardial symptoms and cardiac event recurrence after coronary stent implantation

The recurrence of stenocardial symptoms after percutaneous coronary artery stent implantation is an important limitation of the procedure. The symptoms may appear due to artery stenosis in previously dilated segment (restenosis) or in an uninvolved segment. There have been many attempts to solve the problem for years now, none of them however have been successful.
The aim of the study: The aim of the study was to estimate the influence of the coronary heart disease risk factors and alcohol abstinence on the late results of the PCI with stent implantation.
Patients and methods: The 111 patients, who underwent coronary artery angioplasty with at least one stent implantation, were enrolled into the study. Coronary heart disease risk factors as well as symptoms present before the procedure were retrospectively evaluated, based on hospital records. The presentation of postoperative stenocardial symptoms was prospectively estimated by means of a questionnaire. The frequency of anginal symptoms just after the procedure and in 6-month follow-up, as well as the rate of coronary events defined as re-hospitalizations due to cardiac events, acute MIs, cardiac deaths, and the need for repeated PTCA or surgical revascularization (CABG) were evaluated.
Results: The recurrent symptoms were found in 44 cases (39.6%). One patient died and 3 underwent surgical revascularization (CABG), including one patient operated on due to acute stent implantation complication. The progression of angina (increase of CCSł1) was diagnosed in 33 patients. In 9 cases restenosis was documented by angiography (though coronary angiography was performed in certain cases of symptomatic deterioration only). De novo lesions were found in 2 patients. Two patients underwent CABG and 7 underwent second PTCA. Patients were divided into two groups: group A – without symptom relapse and group B – complaining of recurrent symptoms. The serum cholesterol levels were significantly higher in group B (239±43 mg%) in 6-month follow-up comparing with group A (211±34 mg%) (p<0.05). The cut-off cholesterol level, above which the risk of symptom recurrence raised dramatically, was 230 mg%. The rate of symptom relapse was lower among patients who continued drinking alcohol than in teetotallers (23% vs. 50%) (p=0.007). There were no differences in lipid profiles before the stent implantation in both groups. No association was found between alcohol consumption and coronary heart disease risk factors. Smoking, diabetes mellitus, arterial hypertension and previous myocardial infarction had no prognostic value to determine symptom recurrence. More than one stent implantation during PTCA procedure was also not a symptom relapse predisposing factor. The higher predisposition of any of the vessels for a sequel restenosis was also excluded.
Conclusions: