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J Hollman

Publications and source records attributed to J Hollman.

59 records · Page 4Linked to original sources
PubMedDate not supplied

Serum lipoprotein levels fail to predict postangioplasty recurrent coronary artery stenosis.

A prospective study to explore the role of serum lipoproteins in the development of recurrent stenosis after percutaneous transluminal coronary angioplasty was conducted on serum samples from 103 patients. Serum was collected at the time of angioplasty and evaluated for total cholesterol, total triglycerides (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein cholesterol, and apolipoproteins A1 and B. In addition, LDL cholesterol/HDL cholesterol ratios and apolipoprotein B/A1 ratios were calculated for each sample. Information was then gathered from four years of follow-up after angioplasty, which was sufficient to establish the presence or absence of recurrent stenosis in 87 patients (68 males and 19 females). Stenosis recurred in 31 of the 87 patients (36%); the rate was similar for males (35%) and females (37%). Univariate analysis of the total patient population revealed no statistically significant difference in values for any of these lipoprotein parameters between success and recurrence groups. Likewise, multivariate analysis revealed no combination of lipoprotein values to be associated with success or recurrence. Findings were similar for the males alone and the total group of males and females. The female group was too small for separate statistical analysis. The power of this study to detect meaningful differences in each of these parameters except TG was at least 80%. These results do not support the hypothesis that lipoprotein factors influence the development of recurrent stenosis in patients undergoing coronary angioplasty.

Angioplasty, Balloon↗
PubMedDate not supplied

Risk factors for recurrent stenosis following successful coronary angioplasty.

The major limitation of coronary angioplasty is recurrent stenosis. Patient, clinical, and procedural factors at the time of angioplasty were correlated with the presence or absence of angiographically documented recurrent stenosis or continued patency. Patients with single-vessel, multilesion disease had a lower incidence of recurrence than those with single-vessel, single-lesion disease (22.2% v 37.3%). Patients with multivessel disease had the highest rate of recurrent stenosis (45%). Sex and age did not predict recurrence. Patients with more severe symptoms, patients without prior myocardial infarction (MI), and insulin-dependent diabetic patients were more likely to have recurrent stenosis. Of the lesion variables, a severe stenosis or a low gradient before angioplasty, the absence of an intimal tear after angioplasty, and left anterior descending artery lesions correlated with a higher recurrence rate. Inflation times greater than or equal to 30 seconds and a greater total number of inflations correlated with a higher recurrence rate. Multivariate analysis showed the following variables to be important predictors of recurrence: Canadian Heart Class, history of myocardial infarction, gradient before angioplasty, artery dilated, number of inflations, severity of stenosis before angioplasty, and insulin-dependent diabetes mellitus.

Adult↗
PubMedDate not supplied

Risk factors for in-hospital mortality associated with coronary angioplasty.

The clinical, angiographic, and procedural findings in 40 in-hospital deaths among 5,000 consecutive percutaneous transluminal coronary angioplasties were reviewed. Compared to the total group, the mortality group had a higher proportion of women, older age, and more extensive coronary disease. Angioplasty was performed as an emergency procedure in 21 of the 40 patients who died. Eighteen presented with an evolving acute myocardial infarction and 17 with unstable angina. Most patients presented in critical condition prior to angioplasty: 18 patients were in cardiogenic shock and 5 patients were on cardiopulmonary resuscitation. Among 13 patients who died following elective angioplasty, the salient feature was acute vessel closure or dissection in 7 patients and failed dilatation of a saphenous vein graft in 4 patients.

Age Factors↗