title: One-year outcome after percutaneous coronary intervention for stable and unstable angina pectoris with or without application of general usage of stents in unselected European patient groups.
abstract: The outcome after percutaneous coronary intervention (PCI) of all patients treated for stable and unstable angina pectoris from July 1992 to June 1993 (group A [n = 590], of whom 3.7% received stents) was compared with the outcome in patients treated from July 1996 to June 1997 (group B [n = 768], of whom 64.7% received stents). All patients were followed up for at least 1 year. PCI was performed due to unstable angina in 34.1% and 33.5% of patients in groups A and B, respectively. More patients in group B than in group A had systemic hypertension, previous coronary artery bypass grafting, and PCI. Within 1 year, 42.2% of patients in group A versus 27.2% in group B (p <0.001) either died, had a nonfatal acute myocardial infarction (AMI), or underwent a new revascularization procedure. The difference between the groups persisted after correction for differences in baseline characteristics. No difference was seen in the subgroup that had previously undergone PCI. Mortality (2.0% vs 1.4%, p = NS) and the composite of death plus AMI (6.6% vs 6.1%, p = NS) was similar in groups A and B. The diagnoses of unstable angina and systemic hypertension at the time of the procedure were also predictors of adverse outcome. Thus, in a cohort of patients treated after the general acceptance of stenting, the composite of death, AMI, and/or revascularization procedures was significantly less than that in the cohort treated before this increase in stenting. However, this did not result in a reduced frequency of death or AMI.
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. annika.odell@hjl.gu.se
authors.forename: Annika
authors.initials: A
authors.lastname: Odell
authors.forename: Thorarinn
authors.initials: T
authors.lastname: Gudnason
authors.forename: Tobias
authors.initials: T
authors.lastname: Andersson
authors.forename: Håkan
authors.initials: H
authors.lastname: Jidbratt
authors.forename: Lars
authors.initials: L
authors.lastname: Grip
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000628:therapy*; D000789:Angina, Unstable / Q000150:complications / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D010043:Outcome and Process Assessment, Health Care; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome