Long-term clinical outcome after coronary balloon angioplasty: identification of a population at low risk of recurrent events during 17 years of follow-up.
AIMS: This study reports the clinical outcome, up to 17 years, of the first 856 consecutive patients treated by coronary angioplasty at a single centre and attempts to identify a subgroup of patients at low risk of adverse events. METHODS AND RESULTS: Follow-up status was established via hospital and general practitioner records and the civil registry. Median follow-up was 16 years. The overall 5-, 10-, 15- and 17-year survival was 90%, 78%, 64% and 58%, respectively and corresponding event-free survival was 53%, 33%, 22% and 19%. After 32% of patients had experienced a major adverse cardiac event in the first year, the annual coronary re-intervention incidence thereafter and, even beyond year 10, remained at 2%--3%. Using multivariable Cox regression, significant independent predictors of mortality were advanced age, diabetes, multivessel disease and impaired left ventricular function at the time of PTCA. A subgroup of 26% of the patients with none of these risk factors had a survival rate similar to the general Dutch population matched for age and gender (at 5 years: 96%, at 10 years: 89% and at 15 years: 83%). CONCLUSION: Although the majority of patients (>80%) experienced a further cardiac event during the 17 years after their first angioplasty procedure, in those non-diabetics under 60 years with single-vessel disease and good left ventricular function, prognosis was similar to the general population.
|Keywords||*Angioplasty, Transluminal, Percutaneous Coronary/mortality, Adult, Aged, Angina Pectoris/therapy, Confidence Intervals, Coronary Artery Bypass/mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction/therapy, Predictive Value of Tests, Recurrence, Risk Factors, Survival Analysis, Time, Treatment Outcome|
|Persistent URL||dx.doi.org/10.1053/euhj.2000.2420, hdl.handle.net/1765/12930|
van Domburg, R.T., Foley, D.P., de Feyter, P.J., van der Giessen, W.J., van den Brand, M.J.B.M., & Serruys, P.W.J.C.. (2001). Long-term clinical outcome after coronary balloon angioplasty: identification of a population at low risk of recurrent events during 17 years of follow-up.. European Heart Journal, 22(11), 934–941. doi:10.1053/euhj.2000.2420