Comparative long-term results of coronary angioplasty in single and multivessel disease
R A Henderson1, C Raskino, S Karani
1Department of Cardiology, Guy's Hospital, London, U.K.
Insights
Coronary angioplasty offers good long-term results for both single-vessel and multivessel disease. However, patients with multivessel disease experienced lower survival and higher adverse events after angioplasty compared to single-vessel disease patients.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) management often involves percutaneous coronary intervention (PCI).
- Long-term outcomes comparing PCI in single-vessel disease (SVD) versus multivessel disease (MVD) require continued evaluation.
Purpose of the Study:
- To compare the long-term clinical outcomes of coronary angioplasty in patients with SVD versus MVD.
- To assess survival, adverse cardiac events, and symptom recurrence rates between the two groups.
Main Methods:
- A retrospective analysis of 898 patients undergoing coronary angioplasty.
- Patients were categorized into SVD (448) and MVD (451) groups.
- Clinical status and outcomes were assessed at follow-up, including survival, major adverse cardiac events (MACE), and angina status.
Main Results:
- Five-year actuarial survival was 92.7% for SVD and 85.6% for MVD (RR 2.1).
- MVD patients had higher rates of cardiac death, myocardial infarction (RR 1.8), and subsequent coronary artery bypass surgery (RR 2.5).
- Angina-free rates at follow-up were 72.6% for SVD and 61.3% for MVD; 43.3% of SVD and 35.8% of MVD patients were off anti-anginal medication.
Conclusions:
- Coronary angioplasty provides a favorable long-term prognosis for CAD patients.
- Patients with MVD demonstrate significantly lower survival and event-free survival rates post-angioplasty compared to SVD patients.
- Risk stratification and treatment strategies should consider the extent of coronary artery disease.
Abstract:
The comparative long-term clinical results of coronary angioplasty in 448 patients with single-vessel and 451 patients with multivessel disease are reported. Clinical status was determined at census for 898 patients (99.9%). Actuarial survival at 5 years was 92.7% for single-vessel and 85.6% for multivessel disease patients (relative risk 2.1). Patients with multivessel disease had higher rates of cardiac death and non-fatal myocardial infarction (relative risk 1.8), and coronary artery bypass surgery (relative risk 2.5) than patients with single-vessel disease. At follow-up 72.6% of single-vessel and 61.3% of multivessel disease patients had no angina and 43.3% and 35.8%, respectively, were taking no regular anti-anginal medication. Treatment by coronary angioplasty is associated with a good long-term prognosis, but survival and event-free survival rates are lower in patients with multivessel disease than in patients with single-vessel disease, even after correction for differences in other baseline characteristics.
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