Editorial |

Preventing Cardiac Events and Restenosis After Percutaneous Coronary Intervention

George Sopko, MD, MPH
JAMA. 2002;287(24):3259-3261. doi:10.1001/jama.287.24.3259.
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Treatment of coronary heart disease (CHD), the leading cause of mortality in the United States, has progressed significantly over the past several decades. As new approaches have emerged and become accepted forms of therapy, CHD mortality has steadily decreased. Coronary revascularization by percutaneous coronary intervention (PCI) can provide relief of symptoms and ischemia in patients with CHD by reducing luminal obstruction and improving coronary flow. Since the first percutaneous transluminal coronary angioplasty (PTCA) performed in 1977, the number of PCIs has increased dramatically, with more than 600 000 now performed annually in the United States.1 Despite significant improvements in PCI technology, restenosis remains the major limitation of percutaneous revascularization techniques, with peak occurrence 1 to 3 months following successful dilation. Restenosis rates vary widely depending on the technique, ranging from nearly 0% with sirolimus stents2 and less than 10% with brachytherapy3 to as high as 60% in some studies.4

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