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Published on: May 14, 2013
Retrospective analysis of percutaneous transluminal coronary angioplasty and coronary stenting
Jilin Chen1, Runlin Gao, Qiangjun Cai
1Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
Insights
Percutaneous transluminal coronary angioplasty (PTCA) with stenting shows excellent long-term results in Chinese patients. This combined therapy is recommended for coronary heart disease revascularization.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Percutaneous transluminal coronary angioplasty (PTCA) and coronary stenting are common revascularization procedures.
- Long-term efficacy data for these interventions, particularly in specific populations, are crucial for treatment guidelines.
Purpose of the Study:
- To evaluate the long-term effectiveness of PTCA and coronary stenting in treating CHD.
- To identify factors influencing the efficacy of these coronary revascularization techniques.
- To compare the outcomes of PTCA alone versus PTCA with stenting.
Main Methods:
- A cohort of 790 patients undergoing successful PTCA or PTCA + stent procedures were followed.
- Follow-up was conducted via direct interview or letter, achieving an 84.2% participation rate.
- The study period ranged from 0.9 to 12.7 years, with a mean follow-up of 3.5 years.
Main Results:
- The cardiac event-free survival rates were 88.2% at 1 year and 80.6% at 12.7 years.
- PTCA + stent group showed significantly lower rates of total cardiac events compared to the PTCA-only group.
- Factors positively correlated with cardiac events included acute myocardial infarction (AMI) history and stent implantation; a negative correlation was observed with the number of diseased arteries.
Conclusions:
- PTCA, particularly when combined with stenting, demonstrates highly satisfactory long-term efficacy in Chinese patients.
- PTCA + stent therapy is recommended as a primary treatment strategy for revascularization in patients with coronary heart disease.
- The findings support the widespread adoption of PTCA with stenting for improved long-term outcomes in CHD management.
Objective:
To examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy.
Methods:
A total of 790 patients who underwent successful PTCA and PTCA + stent in this hospital were followed by direct interview or letter. The rate of follow-up was 84.2% and the period of follow-up was 0.9 - 12.7 (3.5 +/- 2.4) years.
Results:
During follow-up, 4 (0.5%) patients died, 22 (2.8%) had nonfatal acute myocardial infarction, 10 (1.3%) had coronary artery bypass surgery, and 98 (12.4%) had repeat PTCA. The rate of recurrent angina pectoris was 31.1%. The cardiac event-free survival rate calculated by the Kaplan-Meier method was 88.2% at 1 year and 80.6% at 12.7 years. Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events. Compared to the PTCA group, patients with PTCA + stent had significantly lower rates of total cardiac events.
Conclusion:
The long-term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA + stent therapy should be the major treatment for revascularization in patients with coronary heart disease.
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