Long term outcome after intracoronary beta radiation therapy.
OBJECTIVE
To determine the long term outcome after intracoronary beta radiation therapy (IRT).


METHODS
Tertiary referral centre.


METHODS
The rate of major adverse cardiac events (MACE) was retrospectively determined in 301 consecutive patients who were treated with IRT. MACE was defined as death, myocardial infarction, or any reintervention. Long term clinical outcome was obtained from an electronic database of hospital records and from questionnaires to the patients and referring physicians. Long term survival status was assessed by written inquiries to the municipal civil registries.


RESULTS
The mean (SD) follow up was 3.6 (1.2) years. The cumulative incidence of MACE at six months was 19.1%, at one year 36.4%, and at four years 58.3%. The target lesion revascularisation (TLR) rate at six months was 12.9%, at one year 28.3%, and at four years 50.4%. From multivariate analysis, dose < 18 Gy was the most significant predictor of TLR. At four years the cumulative incidence of death was 3.8%, of myocardial infarction 13.4%, and of coronary artery bypass surgery 11.3%. Total vessel occlusion was documented in 12.3% of the patients.


CONCLUSIONS
In the long term follow up of patients after IRT, there are increased adverse cardiac events beyond the first six months.
Sianos
G
G
Department of Interventional Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands. g.sianos@erasmusmc.nl
Hoye
A
A
Saia
F
F
van der Giessen
W
W
Lemos
P
P
de Feyter
P J
PJ
Levendag
P C
PC
van Domburg
R
R
Serruys
P W
PW
D001610:Beta Particles / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000401:mortality; D023903:Coronary Restenosis / Q000401:mortality / Q000517:prevention & control / Q000532:radiotherapy*; D003328:Coronary Thrombosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D009204:Myocardial Revascularization / Q000379:methods; D011879:Radiotherapy Dosage; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome