Clinical and angiographic follow-up after coronary angioplasty in patients with two-vessel disease: influence of completeness and adequacy of revascularization on long-term outcome.
To assess the influence of the degree of revascularization on long-term results with angioplasty in multivessel disease, 151 consecutive patients with double-vessel disease and successful angioplasty in at least one vessel were prospectively followed up for a mean of 14 months (range 6 to 30 months) with clinical evaluation, an exercise stress test, and routine angiography. Patients were divided into three groups according to completeness and adequacy of revascularization: group 1--complete revascularization (no residual stenosis > or = 70%, 51 patients); group 2--incomplete but functionally adequate revascularization (residual stenosis > or = 70% in a vessel < 2 mm in diameter or supplying akinetic or dyskinetic segments of the left ventricle, 56 patients); group 3--incomplete and inadequate revascularization (residual stenosis > or = 70% in a vessel > or = 2 mm in diameter supplying normal or hypokinetic segments, 45 patients). There were no late deaths; one myocardial infarction occurred in group 1 patients, three in group 2, and two in group 3 patients (p = NS). Recurrence of angina was lower in group 1 (13 of 51 or 26%) and group 2 (16 of 56 or 28%) compared with group 3 (23 of 45 or 51%, p < 0.01). A positive stress test for ischemia was present in 20 patients (39%) of group 1, in 30 (54%) of group 2, and in 26 patients (58%) of group 3.(ABSTRACT TRUNCATED AT 250 WORDS)
Cavallini
C
C
Divisione di Cardiologia, Ospedale Regionale, Treviso, Italy.
Risica
G
G
Olivari
Z
Z
Marton
F
F
Franceschini
E
E
Giommi
L
L
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome