Six month outcome and determinants of adverse clinical events after successful excimer laser coronary angioplasty. ELCA A.I.S. Multicenter Registry.
OBJECTIVE
To describe the six month outcome and predictors of adverse clinical events following successful excimer laser coronary angioplasty (ELCA).


METHODS
Retrospective analysis of comprehensive data collected at time of initial procedure and during planned follow-up intervals.


METHODS
There were 35 participating institutions throughout the United States.


METHODS
The study population was comprised of 3,069 patients who had successful ELCA and completed follow-up at 6 months, representing 91% of eligible cases. Forty percent had prior balloon angioplasty and 34% had prior bypass surgery.


METHODS
Patient symptomatology was assessed by Canadian Cardiovascular Society functional (CCSF) class. Interim adverse clinical events [death, Q wave myocardial infarction (QMI), repeat intervention, bypass surgery, and a composite end-point] were tracked. Twenty-six pre-ELCA clinical, angiographic and procedural variables were evaluated to assess their ability to predict outcome.


RESULTS
At 6 months, there was 2.8% mortality, 2.5% incidence of QMI, and 28.7% required either repeat intervention or bypass surgery. Overall, 69.2% of patients had no adverse event. In this cohort, the pre-ELCA CCSF class grade was 2.7 +/- 1.2, but at 6 months, it was 0.7 +/- 1.1 (p < 0.001). The multivariate predictors of the composite end point were gender, stenosis location, and rest and unstable angina.


CONCLUSIONS
There is an excellent 6 month outcome after successful ELCA in this selected population with complex coronary artery disease. The majority of patients without interim events enjoy significant alleviation of symptoms. The predictors of adverse events are clinical rather than angiographic.
Klein
L W
LW
Rush Heart Institute, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Litvack
F
F
Holmes
D
D
Margolis
J
J
Rothbaum
D
D
Cummins
F
F
Eigler
N
N
O'Neill
W
W
D017222:Angioplasty, Balloon, Laser-Assisted / Q000009:adverse effects; D017023:Coronary Angiography; D003327:Coronary Disease / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome