One-year follow-up results of the 1985-1986 National Heart, Lung, and Blood Institute's Percutaneous Transluminal Coronary Angioplasty Registry.
In 1,801 patients in the 1985-1986 Percutaneous Transluminal Coronary Angioplasty Registry, overall 1-year mortality was 3.2%, the 1-year myocardial infarction rate was 7.2%, and the 1-year coronary artery bypass surgery rate was 13.2%. In the 78% of the cohort with all lesions successfully dilated and without major procedural complications (successful patients), the corresponding rates were 1.9%, 2.6%, and 6.4%. Nearly 20% of all deaths, 40% of all infarctions, and 25% of all bypass operations occurred in the small subset of patients (6.8%) who sustained periprocedural occlusion. Event rates were higher in patients with multivessel disease than in those with one-vessel disease. At 1 year, angina-free status was reported by approximately three fourths of all surviving patients, regardless of initial success. However, compared with successful patients, unsuccessful patients underwent intervening bypass surgery (42% vs. 6%) to achieve asymptomatic status more frequently. Comparison of the 1-year event rates in the 1985-1986 registry with those in the 1977-1981 registry indicated reductions in all major untoward events. These reductions became apparent after controlling for the more extensive disease of the 1985-1986 registry patients. In contrast, use of repeat angioplasty has increased by 50%. We conclude that the improved initial results reported in the 1985-1986 registry cohort were maintained at 1-year follow-up.
Detre
K
K
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261.
Holubkov
R
R
Kelsey
S
S
Bourassa
M
M
Williams
D
D
Holmes
D
D
Dorros
G
G
Faxon
D
D
Myler
R
R
Kent
K
K
D000787:Angina Pectoris / Q000453:epidemiology; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000401:mortality; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D003331:Coronary Vessels; D005500:Follow-Up Studies; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology; D009316:National Institutes of Health (U.S.); D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D014481:United States