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Long-term clinical outcome after percutaneous transluminal coronary angioplasty with provisional stenting
Michail I Papafaklis1, Katerina K Naka, Lampros Sioros
1Michaelideion Cardiac Center, Ioannina, Greece.
Insights
Long-term follow-up of coronary angioplasty with provisional stenting shows 78% survival at 9 years. Certain patient factors, like age and diabetes, significantly impact outcomes, with nearly half experiencing cardiac events.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Clinical Outcomes Research
Background:
- Long-term follow-up studies are crucial in interventional cardiology despite rapid technological advancements.
- Understanding limitations and guiding future changes in cardiac procedures is essential.
Purpose of the Study:
- To report the 9-year clinical outcomes of patients undergoing coronary angioplasty with provisional stenting.
- To identify factors influencing long-term survival and major adverse cardiac events.
Main Methods:
- Retrospective analysis of 409 consecutive patients treated between 1995-1999.
- Data collection included baseline characteristics, survival, cardiac events, and symptoms via medical records and telephone contact.
- Statistical analysis to determine survival rates and predictive factors.
Main Results:
- 98.5% follow-up achieved in 403 patients.
- Cumulative 9-year survival rate was 78%; survival free from major adverse cardiac events was 55%.
- Independent predictors of survival included age >65, diabetes, hypertension, multivessel disease, and ejection fraction <50%.
Conclusions:
- Long-term survival after coronary angioplasty with provisional stenting is influenced by specific patient factors.
- Approximately 45% of patients experienced a subsequent cardiac event within the 9-year follow-up period.
- Patients with favorable characteristics (younger, non-diabetic, single-vessel disease) had survival rates comparable to the general population.
Objectives:
This study reports the 9-year clinical outcome of 409 consecutive patients, who underwent coronary angioplasty with provisional stenting during the years 1995 to 1999 in the University Hospital of Northwestern Greece.
Background:
Despite the rapid changes of interventional cardiology, long-term follow-up studies are useful for identifying its limitations and indicating future changes.
Methods:
Baseline characteristics and information on survival, major cardiac events and symptoms were retrospectively obtained from medical records or telephone contact. Patient survival rates were calculated and predictive factors for survival and cardiac events were identified.
Results:
Follow-up information was obtained in 403 patients (98.5%). Three hundred and thirty-one patients (82%) were alive with 150 (45%) being symptom free. The cumulative 5- and 9-year survival rates were 87% and 78% respectively, and the corresponding survival free from major adverse cardiac events was 65% and 55%. Independent factors affecting survival were age>65 years, diabetes, hypertension, multivessel disease and ejection fraction<50%, while stenting and the indication of acute myocardial infarction for intervention influenced independently survival from cardiac death. Non-diabetics, aged
Conclusions:
Certain factors influence long-term survival after balloon angioplasty with provisional stenting and almost half of the patients (45%) experience a further cardiac event during a 9 year follow-up period.
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