Percutaneous coronary angioplasty in 1,001 multivessel coronary disease patients: an analysis of different patient subsets.
The prospectively collected data of 1,001 multivessel coronary disease patients who underwent percutaneous transluminal angioplasty (PTCA) was analyzed after categorization into single vessel angioplasty (SVA; group I) and multiple vessel angioplasty (MVA; group II) PTCA groups, which were each compartmentalized into "simple" (group A) and "complex" (group B) cohorts.  Patients were assigned to the SVA or MVA group according to the physician's pre-PTCA assessment of how many lesions would be attempted (intention to treat) and not the number of lesions actually attempted.  A "simple" patient was more likely than a "complex" patient to be clinically improved after PTCA whether or not the patient had a single dilatation (90% vs 78%; P less than 0.05) or multiple dilatations (97% vs 94%; P<0.05).  Similarly, a lesion(s) was more likely to be successfully dilated in the "simple" than in the "complex" group (SVA: 90% vs 82%, P less than 0.05; MVA: 97% vs 91%, P<0.05).  In addition, occluded vessels in the MVA group were more likely to be recanalized than in the SVA group (73% vs 44%, P less than 0.05).  Group I-A patients had a significantly increased (10%) incidence of emergency bypass surgery.  Follow-up, at 84 months, showed that "simple" cohorts had a better survival than the "complex" cohorts (MVA: 95% vs 71%, P less than 0.05; SVA: 90% vs 72%, P less than 0.05); and, nearly two thirds of all successful PTCA patients were angina free.(ABSTRACT TRUNCATED AT 250 WORDS)
Dorros
G
G
Department of Cardiology, St. Luke's Medical Center, Milwaukee, Wisconsin.
Iyer
S S
SS
Hall
P
P
Mathiak
L M
LM
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002983:Clinical Competence; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome