Sport science for salmon and other species: ecological consequences of metabolic power constraints.

For metabolically demanding behaviours, power supply (ATP resynthesis per unit time) is an important constraint on performance. Yet ecology as a discipline lacks a framework to account for these power constraints. We developed such a framework (borrowing concepts from sports science) and applied it to the upriver migration of anadromous fish. Our models demonstrate how metabolic power constraints alters optimal migratory behaviour; in response to strong counter flows, fish minimise cost of transport by alternating between rapid, anaerobically fuelled swimming and holding to restore spent fuels. Models ignoring power constraints underestimated the effect of elevated water temperature on migration speed and costs (by up to 60%). These differences were primarily due to a temperature-mediated reduction in aerobic scope that impairs the ability of fish to rapidly migrate through warm waters. Our framework provides a mechanistic link between temperature-induced reductions in aerobic scope and their ecological consequences for individuals, populations and communities.

A computer method for identifying patterns in electroencephalogram signals.

A computer method is developed for identifying patterns in electroencephalogram (EEG) signals. An EEG numerical signal is transformed into a symbolic series. The simple transformation used here studies the variations between two successive values of the signal. Then, this series is analysed with a symbolic correlation function based on probabilities without bias. The use of large windows, e.g. 1 hour, allows the identification of weak signals hidden by the specific ones. An application of this method to the sleep analysis of a healthy adult shows a periodicity modulo 10 in all derivations. A possible neurophysiological meaning is presented in the discussion.

[Determinants of long-term follow-up after stent implantation in acute myocardial infarction]. / Determinanten des Langzeitverlaufes über drei Jahre nach Stent-Implantation bei akutem Myokardinfarkt.

Coronary stent implantation is an effective treatment of acute myocardial infarction. Little is known about long-term follow-up of patients undergoing stent implantation in the setting of acute myocardial infarction, since most studies restrict the follow-up to six months. The aim was to investigate the clinical follow-up of patients over a period of three years and to identify predictive factors of an adverse cardiovascular outcome. The study retrospectively analyzes a consecutive series of 204 patients receiving stent implantation in the setting of an acute myocardial infarction. Follow-up angiography was performed after 5+/-2 months following myocardial infarction analyzing the incidence of angiographic restenosis. Adverse cardiovascular outcome was defined as cumulative end point including death, myocardial infarction, coronary artery bypass grafting and PTCA/stent implantation of the target vessel occurring in the first three years following myocardial infarction. Multivariate analysis correlated clinical, procedural and angiographic variables with an adverse outcome. Restenosis occurred in 38% of patients. An adverse outcome was observed in 42% of patients. Multivariate analysis identified target vessel CABG, time to treatment >10 h, TIMI flow <3 after stent implantation, number of stents >1, male gender, multivessel disease and arterial hypertension as independent predictors of an adverse cardiovascular outcome. Critical consideration of these risk factors may help to identify patients who are poor candidates for stent implantation in acute myocardial infarction. However, further investigation is required to corroborate the results of this investigation on determinants of a three year follow-up after stent implantation in acute myocardial infarction.

Risk factors for the development of restenosis following stent implantation of venous bypass grafts.

OBJECTIVE: To analyse the variables involved in the high restenosis rate following stent implantation in coronary artery bypass grafts. DESIGN: A retrospective analysis of a consecutive group of patients attending a tertiary centre. PATIENTS: The long term angiographic outcome of 219 stent implantations for individual lesions performed in 191 patients was investigated. Multivariate analysis correlated clinical, procedural, and angiographic variables with the incidence of angiographic restenosis, defined as diameter stenosis > 50% at follow up. RESULTS: Angiographic restenosis was observed in 34% of lesions treated. Multiple logistic regression analysis defined diabetes mellitus (odds ratio 6.91, 95% confidence interval (CI) 2.43 to 9.69), graft recanalisation (2.89, 95% CI 1.18 to 6.63), lesion at the aortic anastomosis (6.98, 95% CI 2.77 to 21.31), lesion at the coronary anastomosis (3.01, 95% CI 1.19 to 7.69), high diameter stenosis after stent placement (7.21, 95% CI 2.66 to 16.81), placement of long stents (2.73, 95% CI 1.09 to 7.39), and implantation of more than one stent (7.31, 95% CI 2.08 to 19.96) as independent predictors of graft in-stent restenosis. CONCLUSIONS: There appears to be a specific risk factor constellation contributing to the high restenosis rate following stent implantation in venous bypass grafts. Critical consideration of these variables may help identify patients who are poor candidates for stent implantation and who may benefit from a different approach.

Analysis of a circular code model.

A circular code has been identified in the protein (coding) genes of both eukaryotes and prokaryotes by using a statistical method called trinucleotide frequency (TF) method [Arquès & Michel (1996). J. theor. Biol. 182, 45-58]. Recently, a probabilistic model based on the nucleotide frequencies with a hypothesis of absence of correlation between successive bases on a DNA strand, has been proposed by Koch & Lehmann [(1997). J. theor. Biol. 189, 171-174] for constructing some particular circular codes. Their interesting method which we call here nucleotide frequency (NF) method, reveals several limits for constructing the circular code observed with protein genes.

Intracoronary administration of dipyridamole prior to percutaneous transluminal coronary angioplasty provides a protective effect exceeding that of ischemic preconditioning.

BACKGROUND: Ischemic preconditioning renders hearts more resistant to the deleterious consequences of ischemia. Adenosine is an important mediator in the induction and maintenance of ischemic preconditioning. Percutaneous transluminal coronary angioplasty (PTCA) allows the investigation of the consequences of ischemia in humans. The severity of myocardial ischemia decreases with subsequent balloon inflations during the course of PTCA. OBJECTIVE: To compare the effect of intracoronary administration of dipyridamole with the effect of consecutive balloon inflations. METHODS: We investigated 30 patients undergoing PTCA of the left anterior descending coronary artery in the setting of stable angina pectoris. Patients were randomly allocated to be administered either 0.5 mg/kg body weight dipyridamole intracoronarily or an equal amount of saline. Patients administered saline served as a control group. All patients were subjected to three consecutive balloon inflations. Severity of myocardial ischemia was assessed in terms of severity of chest pain, electrocardiographic signs of ischemia, and duration of balloon inflation tolerated. RESULTS: Patients administered dipyridamole intracoronarily tolerated significantly longer durations of balloon inflation than did patients in the control group. Severity of anginal pain and extent of electrocardiographic signs of ischemia were significantly lower after intracoronary administration of dipyridamole. The reductions in anginal pain and ST-segment shift caused by intracoronary administration of dipyridamole during the first balloon inflation were even more pronounced than the protection that was afforded by the third balloon inflation for patients in the control group. CONCLUSIONS: Intracoronary administration of dipyridamole prior to PTCA is associated with a significant gain in tolerance of ischemia. The protection afforded by intracoronary administration of dipyridamole is even more pronounced than the effect of ischemic preconditioning.

[Restenosis predictors after stent implantation of venous aortocoronary bypass grafts]. / Restenose-Prädiktoren nach Stent-Implantation aortokoronarvenöser Bypassgefässe.

Follow-up studies after stent implantation of native coronary arteries have reported reduced rates of angiographic restenosis. In contrast, stent implantation in the treatment of obstructive disease of coronary artery bypass grafts is complicated by higher restenosis rates. We sought to determine, if different predictors contribute to the high restenosis rate following stent implantation of coronary artery bypass grafts. We investigated long-term angiographic outcome of 205 stent implantations performed in 177 patients. Multivariate analysis correlated clinical, procedural and angiographic variables with the incidence of angiographic restenosis defined as diameter stenosis > 50% at follow-up. Angiographic restenosis was observed in 34% of lesions treated. Multiple logistic regression analysis defined diabetes mellitus (OR 6.89, CI 2.41-9.69), graft recanalization (OR 2.69, CI 1.08-6.63), lesion at the aortic anastomosis (OR 6.98, CI 2.76-19.25), lesion at the coronary anastomosis (OR 2.95, CI 1.18-7.49), high diameter stenosis after stent placement (OR 7.01, CI 2.64-15.71), placement of long stents (OR 2.78, CI 1.11-7.36) and implantation of more than one stent (OR 7.34, CI 2.08-20.15) as independent predictors of graft in-stent restenosis. Critical consideration of these variables may help to identify patients who are poor candidates for stent implantation and who may benefit from different interventional approaches.

Effect of adjunctive intracoronary adenosine on myocardial ischemia, hemodynamic function and left ventricular performance during percutaneous transluminal coronary angioplasty: clinical access to ischemic preconditioning?

BACKGROUND: Ischemic preconditioning has been defined as a mechanism that renders the heart more resistant to subsequent ischemia. Adenosine plays an important role in the pathogenesis of ischemic preconditioning. OBJECTIVE: To assess whether intracoronary administration of adenosine prevents the deterioration of left ventricular performance and hemodynamic function by allowing adaptation to myocardial ischemia in the setting of percutaneous transluminal coronary angioplasty (PTCA). DESIGN: This was a prospectively randomized doubly blinded trial. METHODS: We investigated 20 patients undergoing PTCA of the left anterior descending coronary artery supplying myocardium with normal left ventricular function in the setting of stable angina pectoris. Patients were randomly allocated to be administered adenosine intracoronarily (20 mg/10 min) or an equal amount of saline, providing a control population. Results of standardized chest pain questionnaires, tolerated inflation times, ST-segment shifts, left ventricular and aortic pressures, isovolumetric phase indexes, and indexes of volume and ejection fraction during the course of PTCA between the two groups were compared. RESULTS: Patients administered adenosine tolerated significantly longer balloon-inflation times (188 +/- 41 versus 153 +/- 36 s; P = 0.03), which were associated with less pronounced signs of ischemia, and exhibited less deterioration of isovolumetric phase indexes during PTCA. Deterioration of left ventricular ejection fraction was slightly less severe with adenosine (72 +/- 5% before PTCA versus 64 +/- 6% during angioplasty) than it was for the control group (71 +/- 7% before PTCA versus 60 +/- 7% during angioplasty; P = 0.11). CONCLUSIONS: Intracoronary application of adenosine prior to coronary angioplasty increases tolerance of ischemia and prevents deterioration of left ventricular hemodynamics during ischemia. One potential explanation of these results is that induction of ischemic preconditioning took place.

Adjunctive intracoronary dipyridamole in the interventional treatment of small coronary arteries: a prospectively randomized trial.

BACKGROUND: Patients undergoing intracoronary stent placement or balloon angioplasty for the treatment of small coronary arteries are at an increased risk of an adverse outcome from a higher incidence of abrupt closure and restenosis. Intracoronary thrombus formation plays a key role in the pathogenesis of abrupt vessel closure and of restenosis. Dipyridamole prevents platelet aggregation by a mechanism that differs from aspirin. The purpose of this study was to investigate the effect of intracoronary dipyridamole on acute complications and restenosis after percutaneous transluminal coronary angioplasty. METHODS: In a prospectively randomized study including 491 dilatations of coronary arteries with a diameter <2.75 mm, additional intracoronary application of dipyridamole was compared with conventional pretreatment consisting of heparin and aspirin. Study end points were defined as incidence of abrupt vessel closure, myocardial infarction, angiographic restenosis, and target vessel revascularization rate. RESULTS: Intracoronary dipyridamole was associated with a significant reduction of abrupt vessel closure (2.8% vs 8.6%; P =.005) and a nonsignificant reduction of myocardial infarction (1.6% vs 4.5%; P =.07) after percutaneous transluminal coronary angioplasty. Net gain 6 months after angioplasty was significantly higher in the dipyridamole group (0.60 +/- 0.35 mm vs 0.42 +/- 0.34 mm; P <.001). However, dipyridamole failed to reduce the incidence of angiographic restenosis (41.6% vs 49.1%; P =.11) and target vessel revascularization rate (20.6% vs 269%; P =.12). CONCLUSIONS: Intracoronary dipyridamole reduces the incidence of adverse cardiovascular events in the first 48 hours after balloon angioplasty of small coronary arteries. Reduction of restenosis rates failed to reach statistical significance. However, a significant increase in net gain was observed. Thus intracoronary application of dipyridamole should be considered in the treatment of small coronary arteries when intracoronary stenting is not appropriate.

Intracoronary dipyridamole reduces the incidence of abrupt vessel closure following PTCA: a prospective randomised trial.

OBJECTIVES: To investigate the effect of intracoronary dipyridamole on the incidence of abrupt vessel closure, myocardial infarction, necessity for bypass grafting, and death following percutaneous transluminal coronary angioplasty (PTCA). PATIENTS: Patients were randomly allocated to receive either conventional pretreatment (heparin 15 000 IU and aspirin 500 mg intravenously) or additional intracoronary dipyridamole (0.5 mg/kg bodyweight). Dipyridamole was administered in 550 PTCA procedures (455 interventions in men, mean (SD) age 59.2 (8.4) years; 74 acute coronary syndromes), while conventional pretreatment was administered in 544 interventions (444 interventions in men 58.3 (7.9) years old; 81 acute coronary syndromes). In 53 interventions bail out stenting was performed for threatened abrupt vessel closure. RESULTS: Intracoronary dipyridamole significantly reduced the incidence of abrupt vessel closure (odds ratio 0.42. 95% confidence interval (CI) 0.22 to 0.79). While abrupt vessel closure occurred in 6.1% of interventions following conventional pretreatment, dipyridamole reduced the incidence to 2.5%. Restricting the analysis to balloon angioplasty, this reduction was observed in patients with stable angina (odds ratio 0.49, 95% CI 0.23 to 0.96) as well as in those with acute coronary syndromes (odds ratio 0.29, 95% CI 0.09 to 0.87). Reduction of secondary end points in the dipyridamole treated patients failed to reach significance in the PTCA group. CONCLUSIONS: Intracoronary dipyridamole before PTCA reduces the incidence of abrupt vessel closure following PTCA for stable angina and acute coronary syndromes.

[Interventional catheter treatment of bypass graft stenosis: comparison of intracoronary stent implantation and balloon angioplasty]. / Katheterinterventionelle Therapie stenosierter Bypassgefässe. Vergleich zwischen intrakoronarer Stent-Implantation und Ballonangioplastie.

BACKGROUND AND OBJECTIVE: Balloon angioplasty of a stenosed bypass graft has a much higher risk of recurrent stenosis than dilatation of a stenosed native coronary artery. Intracoronary stent implantation has established itself as the better treatment of native coronary artery stenosis than conventional balloon angioplasty. However, there is still uncertainty whether intracoronary stent implantation in stenosed bypass vessels gives better long-term results than conventional balloon angioplasty. PATIENTS AND METHODS: Results were retrospectively analyzed of unrandomized 224 primarily successful interventions--122 balloon dilatations and 102 stent implantations--performed between January 1996 and June 1998 on stenosed coronary bypass grafts, re-examined by coronary angiography an average of 6 months later. All but 11 patients were on combined aspirin and ticlopidine antiplatelet aggregation treatment. RESULTS: There was a significantly lower 6-month restenosis rate (30.4%) after stent implantation than after balloon dilatation (51.6%). The re-intervention rate was also significantly lower after stent implantation. CONCLUSION: These data suggest that stent implantation of stenosed coronary bypass grafts under cover of platelet-aggregation inhibition with aspirin and ticlopidine provides a lower restenosis and thus higher revascularization rate than conventional balloon dilatation.

An evolutionary analytical model of a complementary circular code.

The subset X0=[AAC,AAT,ACC,ATC,ATT,CAG,CTC,CTG, GAA,GAC,GAG,GAT,GCC,GGC,GGT,GTA,GTC,GTT,TAC,TTC] of 20 trinucleotides has a preferential occurrence in the frame 0 (reading frame established by the ATG start trinucleotide) of protein (coding) genes of both prokaryotes and eukaryotes. This subset X0 is a complementary maximal circular code with two permutated maximal circular codes X1 and X2 in the frames 1 and 2 respectively (frame 0 shifted by one and two nucleotides respectively in the 5'-3' direction). X0 is called a C3 code (Arquès and Michel, 1997, J. Biosyst 44, 107-134). A quantitative study of these three subsets X0, X1 and X2 in the three frames 0, 1 and 2 of eukaryotic protein genes shows that their occurrence frequencies are constant functions of the trinucleotide positions in the sequences. The frequencies of X0, X1 and X2 in the frame 0 of eukaryotic protein genes are 48.5%, 29% and 22.5% respectively. These properties are not observed in the 5' and 3' regions of eukaryotes where X0, X1 and X2 occur with variable frequencies around the random value (1/3). Several frequency asymmetries unexpectedly observed, e.g. the frequency difference between X1 and X2 in the frame 0, are related to a new property of the C3 code X0 involving substitutions. An evolutionary analytical model at three parameters (p, q, t) based on an independent mixing of the 20 codons (trinucleotides in the frame 0) of X0 with equiprobability (1/20) followed by t approximately 4 substitutions per codon according to the proportions p approximately 0.1, q approximately 0.1 and r = 1 - p - q approximately 0.8 in the three codon sites respectively, retrieves the frequencies of X0, X1 and X2 observed in the three frames of protein genes and explains these asymmetries. The complex behaviour of these analytical curves is totally unexpected and a priori difficult to imagine. Finally, the evolutionary analytical method developed could be applied to the phylogenetic tree reconstruction and the DNA sequence alignment.

[Effect of intracoronary dipyridamole administration on the incidence of restenosis after PTCA. A prospective randomized study]. / Einfluss einer intrakoronaren Dipyridamol-Applikation auf die Inzidenz der Restenose nach PTCA. Eine prospektiv randomisierte Untersuchung.

BACKGROUND: Restenosis after PTCA remains a serious long-term complication of balloon angioplasty occurring in 30 to 50% of patients. Platelets play a crucial role in the pathogenesis of restenosis following PTCA. Dipyridamole has been shown to inhibit platelet aggregation in humans. Its action as an antithrombotic drug can be attributed to different mechanisms including inhibition of platelet phosphodiesterase and inhibition of the cellular uptake of adenosine. PATIENTS AND METHODS: The purpose of the following study was to investigate the effect of an intracoronary infusion of dipyridamole on the incidence of angiographic and clinical restenosis. In 763 balloon angioplasties patients were randomly allocated to receive either conventional pretreatment (heparin 15000 IE, aspirin 500 mg i.v.) or an additional intracoronary infusion of dipyridamole (0.5 mg/kg body weight). Conventional pretreatment was performed in 388 interventions (61 interventions in women, age 60.5 +/- 8.7 years; 47 interventions for acute coronary syndromes); in 375 interventions additional intracoronary dipyridamole was infused (58 interventions in women, age = 59.6 +/- 9.6 years; 57 interventions for acute coronary syndromes). RESULTS: As compared to conventional pretreatment intracoronary dipyridamole application was associated with a reduction in angiographic restenosis from 43.0% to 36.8% and a reduction of target vessel revascularisation by 15.5% but failed to reach statistical significance. These results were due to an increase in net gain following dipyridamole application. CONCLUSION: Intracoronary pretreatment with dipyridamole prior to PTCA fails to reduce the incidence of angiographic restenosis and target vessel revascularisation significantly. However, a moderate improvement of long-term follow-up can be achieved.

[Differential interventional therapy of coronary heart disease]. / Interventionelle Differentialtherapie der koronaren Herzkrankheit.

Currently, catheter-based coronary therapy is performed using multiple interventional devices. Conventional balloon dilatation is still the dominating therapeutic modality with sufficient results in the majority of coronary lesions. Several alternative new devices were developed to improve acute results and long-term patency compared to balloon dilatation. With use of these devices (stents, coronary atherectomy, laser angioplasty or high speed rotablator) not every coronary lesion can be successfully treated, but several special indications for a differential indication of each of these systems have been found in randomized trials or clinical use. In this review, potential catheter-based strategies for a differential interventional treatment of patients with coronary artery disease are discussed.

[Is there a prognostic indication for PTCA?]. / Gibt es eine prognostische Indikation zur PTCA?

Coronary angioplasty is classically indicated to remove a high grade stenosis of a major coronary vessel supplying a large myocardial territory in a symptomatic patient with proven myocardial ischemia. The coronary anatomy has to be suitable for PTCA to ensure a high success rate for the procedure. PTCA is performed to remove symptoms and myocardial ischemia to improve the prognosis of the patient. In contrast to this, the term "prognostic indication" describes an interventional approach to an angiographically documented high grade stenosis in an asymptomatic patient without proven myocardial ischemia thereby hoping to improve the prognosis of this patient. It has to be expected, that up to 20% of all patients treated by balloon angioplasty and 10% of all stented patients are treated with respect to a "prognostic indication". Until now, there are no statistically significant large-scale studies supporting a benefit of an interventional therapy performed with a "prognostic indication" in asymptomatic patients without ischemia. Nevertheless, some certain subgroups of patients may be candidates for a "prognostic indication" to angioplasty compared to the results of medical therapy. In patients treated interventionally for a "prognostic indication" the acute and long-term individual risk of the underlying coronary disease must be carefully weighted against the risk of the interventional procedure.

[Can recurrences be mechanically prevented?]. / Lassen sich Rezidive mechanisch verhindern?

The success of interventional catheter based therapy of coronary artery disease is still limited by a high rate of chronic restenosis. Using alternative mechanical techniques, there is increasing evidence that restenosis can be prevented in certain subsets of patients by optimized balloon angioplasty, DCA and stenting as well as by the combined approach of primary tissue removal with adjunctive stent implantation. This article summarizes the mechanical techniques of restenosis prevention or reduction that have been documented in controlled trials. Additional pharmacologic interventions and possibly genetic and/or radiotherapeutic approaches will be highly important for future reduction of restenosis.

An evolutionary analytical model of a complementary circular code simulating the protein coding genes, the 5' and 3' regions.

The self-complementary subset T0 = X0 [symbol: see text] ¿AAA, TTT¿ with X0 = ¿AAC, AAT, ACC, ATC, ATT, CAG, CTC, CTG, GAA, GAC, GAG, GAT, GCC, GGC, GGT, GTA, GTC, GTT, TAC, TTC¿ of 22 trinucleotides has a preferential occurrence in the frame 0 (reading frame established by the ATG start trinucleotide) of protein (coding) genes of both prokaryotes and eukaryotes. The subsets T1 = X1 [symbol: see text] ¿CCC¿ and T2 = X2 [symbol: see text] ¿GGG¿ of 21 trinucleotides have a preferential occurrence in the shifted frames 1 and 2 respectively (frame 0 shifted by one and two nucleotides respectively in the 5'-3' direction). T1 and T2 are complementary to each other. The subset T0 contains the subset X0 which has the rarity property (6 x 10(-8) to be a complementary maximal circular code with two permutated maximal circular codes X1 and X2 in the frames 1 and 2 respectively. X0 is called a C3 code. A quantitative study of these three subsets T0, T1, T2 in the three frames 0, 1, 2 of protein genes, and the 5' and 3' regions of eukaryotes, shows that their occurrence frequencies are constant functions of the trinucleotide positions in the sequences. The frequencies of T0, T1, T2 in the frame 0 of protein genes are 49, 28.5 and 22.5% respectively. In contrast, the frequencies of T0, T1, T2 in the 5' and 3' regions of eukaryotes, are independent of the frame. Indeed, the frequency of T0 in the three frames of 5' (respectively 3') regions is equal to 35.5% (respectively 38%) and is greater than the frequencies T1 and T2, both equal to 32.25% (respectively 31%) in the three frames. Several frequency asymmetries unexpectedly observed (e.g. the frequency difference between T1 and T2 in the frame 0), are related to a new property of the subset T0 involving substitutions. An evolutionary analytical model at three parameters (p, q, t) based on an independent mixing of the 22 codons (trinucleotides in frame 0) of T0 with equiprobability (1/22) followed by t approximately 4 substitutions per codon according to the proportions p approximately 0.1, q approximately 0.1 and r = 1 - p - q approximately 0.8 in the three codon sites respectively, retrieves the frequencies of T0, T1, T2 observed in the three frames of protein genes and explains these asymmetries. Furthermore, the same model (0.1, 0.1, t) after t approximately 22 substitutions per codon, retrieves the statistical properties observed in the three frames of the 5' and 3' regions. The complex behaviour of these analytical curves is totally unexpected and a priori difficult to imagine.

Acute complications and restenosis in women undergoing percutaneous transluminal coronary angioplasty. Is it possible to define sex differences and to determine risk factors?

BACKGROUND: Several investigators report a sex bias in the treatment of coronary artery disease. This study attempts to define sex differences in the outcome of percutaneous transluminal coronary angioplasty (PTCA) and to determine risk factors contributing to these results. RESULTS: Data were collected from 1082 patients (887 men and 195 women). In women, the risk of abrupt vessel closure (8.1% versus 2.5%, odds ratio 3.46) and of myocardial infarction (6.2% versus 1.2%, odds ratio 5.58) following PTCA for stable angina pectoris was significantly increased. History of myocardial infarction and PTCA of a vessel of less than 3.0 mm diameter predicted abrupt vessel closure in women. Age and cardiovascular risk factors were not predictors. The incidence of restenosis did not differ significantly (angiographic restenosis in women 36.1% versus 40.8% in men, P=0.34). CONCLUSIONS: A significantly increased risk of acute complications could only be documented in women undergoing PTCA for stable angina pectoris and not in acute coronary syndrome. Long-term outcome was similar between the two sexes.