We studied 29 patients (age 64 ± 6, 23 M) with stable coronary artery disease and isolated stenosis (> 75%) of the LAD coronary artery who underwent successful PCI with stent implantation. Coronary blood flow (CBF) velocity response to adenosine and to cold-pressor test (CPT) was assessed in the LAD coronary artery by transthoracic Doppler echocardiography 24 h and 3 months after PCI. The primary end-point was a combination of death, admission for acute coronary syndromes (ACS) or target vessel revascularization (TVR).
No death or ACS occurred during 36 months of follow-up, but TVR was performed in 5 patients (17.2%). CBF response to CPT at 3 months after PCI was 1.31 ± 0.2 vs. 1.71 ± 0.4 in patients with or without TVR, respectively (p = 0.03), whereas CBF response to adenosine at 3 months in these two groups was 1.70 ± 0.3 vs. 2.05 ± 0.4 (p = 0.059).
Our data suggest that, in patients with successful PCI of LAD coronary artery stenosis, lower CBF response to the endothelium-dependent vasodilator stimulus CPT is associated with long-term recurrence of restenosis.