Circulation, Vol 77, 820-829, Copyright © 1988 by American Heart Association
JD Talley, JW Hurst, SB King 3d, JS Douglas Jr, GS Roubin, AR Gruentzig, HV Anderson and WS Weintraub
This study was performed to define the 5 year clinical status of 427
patients who underwent percutaneous transluminal coronary angioplasty
(PTCA) in 1981. Their mean age was 54 +/- 10 years (+/- 1 SD). Sixty- one
percent had unstable angina, 23% had prior myocardial infarction, 86% had
one-vessel disease, and 92% had normal left ventricular function.
Sixty-seven percent of patients had left anterior descending artery
stenosis. Angiographic success was achieved in 84% of patients. Coronary
bypass surgery was required in 9.6% of patients, in 5.9% as an emergency
procedure. There were no in-hospital deaths. Follow-up at 5 years was 100%
complete. There were 15 late deaths (96.3 +/- 1.0% survival), including
seven of cardiac cause (98.1 +/- 0.7% cardiac survival). Myocardial
infarction occurred in 24 patients (94% freedom from myocardial
infarction), coronary bypass surgery was required in 63 (84% freedom from
bypass surgery), and 365 patients (85%) were asymptomatic at follow-up. At
5 years, 83 patients (20%) had required an additional PTCA. Unstable angina
pectoris and proximal left anterior descending coronary artery stenoses
were present in 162 patients. The overall survival and cardiac survival in
this subset was 94.4 +/- 1.8% and 98.1 +/- 1.1%, respectively. The
excellent survival and low event rates over 5 years in this population
support the concept that PTCA is safe and effective for patients with
symptomatic angina pectoris, single-vessel disease, and normal left
ventricular function.
ARTICLES
Clinical outcome 5 years after attempted percutaneous transluminal coronary angioplasty in 427 patients
Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Emory University Hospital, Atlanta, GA 30322.
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