Long-term follow-up of coronary angioplasty: the 1977-1981 National Heart, Lung, and Blood Institute registry

Eur Heart J. 1989 Dec:10 Suppl G:36-41. doi: 10.1093/eurheartj/10.suppl_g.36.

Abstract

Between September 1977 and September 1981, 1587 consecutive patients underwent a first coronary angioplasty (PTCA) at 16 clinical centres. After excluding patients with prior coronary bypass surgery (CABG) and left main or minimal vessel disease, 1390 were available for in-hospital and long-term follow-up. Mean duration of follow-up was 5.9 years (range 0-9.0 years). PTCA was successful (all attempted lesions reduced greater than or equal to 20%) in 882 patients (63.4%) and, overall, 624 patients (44.9%) had complete (COREV) and 766 (55.1%) incomplete (INCOREV) revascularization or a failed PtCA. In-hospital events included death in 0.7%, myocardial infarction (MI) in 5.0% and CABG in 24.0% of patients. Patients with COREV had significantly lower rates of these events than the INCOREV group. At 6 years, mortality in all registry patients was 6.5% and MI rate 15.0%; CABG was performed after the initial hospitalization in 15.5% of patients and repeat PTCA in 19.1%. All events, except repeated PTCA, were less frequent in the COREV than the INCOREV group. Among patients with a successful first PTCA, cumulative 6-year mortality was 5.8% and incidence of MI 10.8%; 16.9% underwent CABG and 24.7% repeat PTCA during follow-up. CABG was slightly more frequent in INCOREV than COREV patients with successful PTCA, but all other events were similar in the two groups, suggesting that INCOREV 'by intent' has a good prognosis. In patients with INCOREV, mortality and incidence of MI were higher during follow-up for patients with multivessel rather than single vessel disease. However, the incidence of CABG and repeat PTCA was similar in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary*
  • Coronary Disease / diagnosis
  • Coronary Disease / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • National Institutes of Health (U.S.)
  • Prospective Studies
  • Recurrence
  • Registries*
  • Retrospective Studies
  • Risk Factors
  • United States