Outcome ≥10 Years After Successful Percutaneous Transluminal Coronary Angioplasty

• Published in: The American journal of cardiology Vol. 79; no. 8; pp. 1005 - 1011
• Main Authors: Hasdai, David, Bell, Malcolm R, Grill, Diane E, Berger, Peter B, Garratt, Kirk N, Rihal, Charanjit S, Hammes, LaVon N, Holmes, David R
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.04.1997; Elsevier
• Subjects: Aged; Angioplasty, Balloon, Coronary; Biological and medical sciences; Coronary Artery Bypass; Coronary Disease - complications; Coronary Disease - mortality; Coronary Disease - physiopathology; Coronary Disease - therapy; Diseases of the cardiovascular system; Female; Humans; Incidence; Male; Medical sciences; Middle Aged; Multivariate Analysis; Myocardial Infarction - etiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; Risk; Treatment Outcome; Ventricular Dysfunction, Left - etiology; Human; Prognosis; Treatment; Follow up study; Coronary artery; Instrumentation therapy; Instrumental dilatation; Survival; Elderly; Percutaneous route
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(97)00038-6

Patients (n = 611) after successful percutaneous transluminal coronary angioplasty were prospectively followed over 10 to 16 years for major adverse events. The effect of gender, extent of coronary artery disease, left ventricular dysfunction, and age on occurrence of adverse events were analyzed in detail. The incidence of death, Q-wave myocardial infarction, and coronary bypass surgery was 23.1%, 3.9%, and 32.7%, respectively. Men and women had similar mortality (p = 0.13) and Q-wave myocardial infarction (p = 0.57), but men had more coronary bypass surgery (p = 0.06). Patients with multivessel disease had higher mortality (p <0.0001), and patients with 3-vessel disease had a higher incidence of Q-wave myocardial infarction (p = 0.04) and coronary bypass surgery (p <0.001). Left ventricular dysfunction was associated with higher mortality (p <0.0001) and coronary bypass surgery (p = 0.045), but not Q-wave myocardial infarction (p = 0.99). Mortality was higher in elderly patients (p <0.0001), but the incidence of Q-wave myocardial infarction was similar (p = 0.64). Older patients underwent coronary bypass surgery less often (p = 0.004). By multivariate analysis, only the extent of coronary disease (relative risk [RR] 1.71, confidence interval [CI] 1.34 to 2.19; p = 0.0001), diabetes mellitus (RR 1.82, CI 1.28 to 2.59; p = 0.001), hypertension (RR 1.38, CI 1.08 to 1.96, p = 0.009), male gender (RR 1.30, CI 0.99 to 1.71, p = 0.058), and prior myocardial infarction (RR 1.44, CI 1.14 to 1.81, p = 0.002) independently influenced the incidence of major adverse events. We conclude that it is possible to identify patients with worse long-term prognosis after percutaneous transluminal coronary angioplasty based on clinical and angiographic parameters. Patients after successful percutaneous transluminal coronary angioplasty were followed over 10 to 16 years for adverse events. By multivariable analysis, the extent of coronary artery disease, diabetes mellitus, hypertension, male gender, and prior myocardial infarction independently influenced the incidence of a composite end point of death, Q-wave myocardial infarction, or coronary bypass surgery.