title: Results of interventional treatment of stress positive coronary artery disease.
abstract: The aim of this study was to define the impact of percutaneous coronary intervention (PCI) including stenting in patients with stress-positive stable coronary artery disease on long-term prognosis and symptoms. A group of 1,018 patients were identified from the angiographic and single-photon emission computed tomographic (SPECT) databases (technetium-99m sestamibi or tetrofosmin at rest and during stress) January 1, 2000, to December 31, 2003, to have significant coronary artery disease (>50% diameter stenosis on quantitative coronary angiography) and positive SPECT findings. Two hundred sixty-six patients were medically treated. Seven hundred fifty-two patients with positive SPECT findings who underwent PCI were matched to 266 patients of similar age, gender, number and location of stenotic arteries, left ventricular function, and size of SPECT perfusion defect who underwent medical treatment. Clinical events (death, nonfatal myocardial infarction, and revascularization) as well as clinical symptoms (angina or dyspnea, Canadian Cardiovascular Society class II to IV) were determined after a follow-up period of 6.4 +/- 1.2 years. In 524 of the 532 patients (98%), clinical follow-up was obtained. There were no differences between the PCI and medical groups in the frequencies of death (13.5% vs 10.9%) and myocardial infarction (5.3% vs 5.6%) during follow-up. PCI patients had more revascularization procedures <1 year after choice of treatment modality (14.7% vs 6.0%, p <0.002). During the subsequent follow-up period (>1 year), the 2 groups did not differ in the frequency of revascularization procedures. At the end of follow-up, patients in the PCI group complained less frequently of angina pectoris (38% vs 49%, p = 0.014). In conclusion, in patients with stress-positive stable coronary artery disease, PCI including stenting did not reduce mortality or rate of nonfatal myocardial infarction. The PCI group complained less frequently of angina pectoris at long-term follow-up.
authors.affiliation: Medical Clinic I, University RWTH Aachen, Aachen, Germany.
authors.forename: Umar
authors.initials: U
authors.lastname: Adamu
authors.forename: Daniela
authors.initials: D
authors.lastname: Knollmann
authors.forename: Wael
authors.initials: W
authors.lastname: Alrawashdeh
authors.forename: Bader
authors.initials: B
authors.lastname: Almutairi
authors.forename: Verena
authors.initials: V
authors.lastname: Deserno
authors.forename: Eduard
authors.initials: E
authors.lastname: Kleinhans
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schäfer
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D000319:Adrenergic beta-Antagonists; D009566:Nitrates