Background: To assess long-term survival in unselected patients with coronary artery disease in who an invasive approach is considered. Methods: All patients with significant coronary artery disease who were presented for coronary revascularisation to two tertiary centres in 1992 were included. Follow-up data were collected in September 2002. Multivariate Cox' proportional-hazards regression analysis was applied to assess the independent relation between variables and 10-year survival. Results: A total of 877 patients were included in this analysis. Mean age was 62 and the most common clinical diagnosis was chronic stable angina (60%). Diabetes was present in 12% of the patients. During the follow-up period, 233 patients (27%) died. Predictors of long-term survival were increasing age, diabetes, peripheral vascular disease and a decreased left ventricular function. Compared to medical treated patients, those treated with revascularisation (either by PCI or CABG) had a decreased long-term mortality (p<0.05). Of the patients with PCI 27% had died, compared to 24% in those who had CABG and 36% of those who were treated medically. However, after adjusting for differences in baseline variables, conservative treatment was no significant predictor of long-term mortality. After multivariable analyses, increasing age, decreased left ventricular function and diabetes were independent predictors of long-term mortality. Conclusions: In patients with coronary artery disease in whom an invasive approach is considered, increasing age, impaired left ventricular function and diabetes are the strongest predictors of long-term mortality. After adjustments for differences in baseline variables, invasive treatment is not associated with a lower long-term mortality.

Coronary artery disease, Follow-up, Invasive treatment, Mortality, Prognosis,
International Journal of Cardiology
Erasmus MC: University Medical Center Rotterdam

Breeman, A, Timmer, J.R, Ottervanger, J.P, Kolkman, E, de Kluiver, E, Rigter, H, … Zijlstra, F. (2005). Long-term follow-up after invasive approach of coronary artery disease in daily practice. International Journal of Cardiology, 105(2), 186–191. doi:10.1016/j.ijcard.2004.12.028