Clinical outcome 10 years after attempted percutaneous transluminal coronary angioplasty in 856 patients

Catheterization Laboratory, Erasmus University, Rotterdam, The Netherlands.

OBJECTIVES: This study reports the 10-year outcome of 856 consecutive patients who underwent attempted coronary angioplasty at the Thoraxcenter during the years 1980 to 1985. BACKGROUND: Coronary balloon angioplasty was first performed in 1977, and this procedure was introduced into clinical practice at the Thoraxcenter in 1980. Although advances have been made, extending our knowledge of the long-term outcome in terms of survival and major cardiac events remains of interest and a valuable guide in the treatment of patients with coronary artery disease. METHODS: Details of survival, cardiac events, symptoms and medication were retrospectively obtained from the Dutch civil registry, medical records or by letter or telephone or from the patient's physician and entered into a dedicated data base. Patient survival curves were constructed, and factors influencing survival and cardiac events were identified. RESULTS: The procedural clinical success rate was 82%. Follow-up information was obtained in 837 patients (97.8%). Six hundred forty-one patients (77%) were alive, of whom 334 (53%) were symptom free, and 254 (40%) were taking no antianginal medication. The overall 5- and 10-year survival rates were 90% (95% confidence interval [CI] 87.6% to 92.4%) and 78% (95% CI 75.0% to 81.0%), respectively, and the respective freedom from significant cardiac events (death, myocardial infarction, coronary artery bypass surgery and repeat angioplasty) was 57% (95% CI 53.4% to 60.6%) and 36% (95% CI 32.4% to 39.6%). Factors that were found to adversely influence 10-year survival were age > or = 60 years (> or = 60 years [67%], 50 to 59 years [82%], < 50 years [88%]), multivessel disease (multivessel disease [69%], single-vessel disease [82%]), impaired left ventricular function (ejection fraction < 50% [57%], > or = 50% [80%]) and a history of previous myocardial infarction (previous myocardial infarction [72%], no previous infarction [83%]). These factors were also found to be independent predictors of death during the follow-up period by a multivariate stepwise logistic regression analysis. Other factors tested, with no influence on survival, were gender, procedural success and stability of angina at the time of intervention. CONCLUSIONS: The long-term prognosis of patients after coronary angioplasty is good, particularly in those <60 years old with single-vessel disease and normal left ventricular function. The majority of patients are likely to experience a further cardiac event in the 10 years after their first angioplasty procedure.

This article has been cited by other articles:

				B. o Lagerqvist, S. Husted, F. Kontny, U. Naslund, E. Stahle, E. Swahn, L. Wallentin, and FRISC-II Investigators A long-term perspective on the protective effects of an early invasive strategy in unstable coronary artery disease: Two-year follow-up of the FRISC-II invasive study J. Am. Coll. Cardiol., December 4, 2002; 40(11): 1902 - 1914. [Abstract] [Full Text] [PDF]

				P. W. J. C. Serruys, P. de Feyter, C. Macaya, N. Kokott, J. Puel, M. Vrolix, A. Branzi, M. C. Bertolami, G. Jackson, B. Strauss, et al. Fluvastatin for Prevention of Cardiac Events Following Successful First Percutaneous Coronary Intervention: A Randomized Controlled Trial JAMA, June 26, 2002; 287(24): 3215 - 3222. [Abstract] [Full Text] [PDF]

				B.A. van Hout and M.L. Simoons Cost-effectiveness of HMG coenzyme reductase inhibitors. Whom to treat? Eur. Heart J., May 1, 2001; 22(9): 751 - 761. [Abstract] [PDF]

				R.F Veldkamp, S.D.A Valk, R.T van Domburg, L.A van Herwerden, and K Meeter Mortality and repeat interventions up until 20 years after aorto-coronary bypass surgery with saphenous vein grafts. A follow-up study of 1041 patients Eur. Heart J., May 1, 2000; 21(9): 747 - 753. [Abstract] [PDF]

				D. A. Halon, M. Y. Flugelman, A. Merdler, H. Rennert, J. Shahla, and B. S. Lewis Long-term (10-year) outcome in patients with unstable angina pectoris treated by coronary balloon angioplasty J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1603 - 1609. [Abstract] [Full Text] [PDF]

				R. D. Anderson, E. M. Ohman, D. R. Holmes Jr., R. A. Harrington, G. W. Barsness, N. M. Wildermann, H. R. Phillips, E. J. Topol, and R. M. Califf Prognostic value of congestive heart failure history in patients undergoing percutaneous coronary interventions J. Am. Coll. Cardiol., October 1, 1998; 32(4): 936 - 941. [Abstract] [Full Text] [PDF]

				S. R. Gundry, M. A. Romano, O. H. Shattuck, A. J. Razzouk, and L. L. Bailey Seven-year follow-up of coronary artery bypasses performed with and without cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., June 1, 1998; 115(6): 1273 - 1278. [Abstract] [Full Text] [PDF]

				EXCELLENT 10-YEAR OUTCOMES AFTER PTCA Journal Watch (General), June 18, 1996; 1996(618): 2 - 2. [Full Text]