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.
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.
Odell
Annika
A
Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. annika.odell@hjl.gu.se
Gudnason
Thorarinn
T
Andersson
Tobias
T
Jidbratt
Håkan
H
Grip
Lars
L
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