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[Current complication rate of percutaneous transluminal coronary angioplasty in stable and unstable angina]
H J Rupprecht1, R Erbel, R Brennecke
1II. Medizinische Klinik und Poliklinik der Universität Mainz.
Insights
Percutaneous transluminal coronary angioplasty (PTCA) in 930 patients showed a 2.5% severe cardiac complication rate. Unstable angina patients faced higher risks than stable angina patients.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary artery disease management involves interventional procedures.
- Percutaneous transluminal coronary angioplasty (PTCA) is a key treatment for angina.
Purpose of the Study:
- To evaluate the safety and efficacy of PTCA.
- To compare outcomes between stable and unstable angina patients.
Main Methods:
- Retrospective analysis of 930 patients undergoing PTCA between 1983-1986.
- Data collection on mortality, myocardial infarction, and urgent bypass surgery.
Main Results:
- Overall severe cardiac complication rate was 2.5%.
- Unstable angina patients had significantly higher rates of mortality (1.0% vs. 0.2%), infarction (2.0% vs. 0.6%), and emergency operations (2.0% vs. 0.5%).
- A significant decrease in deaths and myocardial infarcts was observed in 1986 compared to 1983-1985.
Conclusions:
- PTCA is associated with a low rate of severe complications.
- Unstable angina represents a higher-risk subgroup for PTCA.
- Continuous improvement in PTCA outcomes may be occurring.
Abstract:
During a four-year period (1983-1986) percutaneous transluminal coronary angioplasty (PTCA) was performed on 930 patients with stable or unstable angina with a mortality rate of 0.4%. A transmural myocardial infarct developed in 1.1% and 1.0% of patients required an urgent aorto-coronary bypass. Thus the total rate of severe cardiac complications was 2.5%. Compared with the years 1983-1985, there was in 1986 a significant fall in the number of deaths and of myocardial infarcts from 2.2% to 0.5% (P less than 0.05), while there was a nonsignificant increase in emergency coronary bypass surgery from 0.7 to 1.3%. Patients with unstable angina compared with those with stable angina had a significantly higher mortality rate (1.0% vs. 0.2%; P less than 0.05), incidence of infarction (2.0% vs. 0.6%; P less than 0.05), and emergency operations (2.0% vs. 0.5%; P less than 0.05). The total risk of a severe cardiac complication was 1.2% for stable and 5.2% for unstable angina (P less than 0.001).