Predictors of adverse outcome 10 years after coronary angioplasty.
To determine which factors before percutaneous transluminal coronary angioplasty (PTCA) predict long-term outcome, we evaluated the clinical follow-up data from 535 patients 10 years after single-vessel PTCA. Events were defined as death, myocardial infarction, bypass surgery or repeat PTCA. During the follow-up period 79 patients (15%) died, 59 patients (11%) suffered a myocardial infarction, 107 patients (20%) had coronary artery bypass surgery and 141 patients (26%) underwent a redilatation. To determine the predictors of 10-year follow-up, 12 patient-related and 9 lesion parameters were analyzed by logistic regression analysis. Mortality was independently increased in patients with diabetes, with multi-vessel disease, after a previous myocardial infarction and in smokers. The presence of multi-vessel disease, symptoms of a higher angina class and younger age increased the risk for undergoing bypass surgery. In the statistical model with lesion parameters, the risk of bypass surgery was decreased if the stenosis was located in the distal segment of the coronary vessel and by a higher minimal luminal diameter before PTCA.


CONCLUSIONS
Logistic regression analysis identified multi-vessel disease, diabetes, smoking and a previous myocardial infarction as independent clinical predictors of an adverse outcome 10 years after coronary angioplasty. Lesion parameters before PTCA seem to be less important with regard to the long-term outcome after PTCA.
Espinola-Klein
C
C
Second Medical Clinic, Johannes-Gutenberg University, Langenbeckstrasse 1, D-55101 Mainz, Germany.
Rupprecht
H J
HJ
Erbel
R
R
Nafe
B
B
Brennecke
R
R
Meyer
J
J
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome