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Title of article :
Long-term outcome of angioplasty for multivessel coronary disease: importance and price of complete revascularization
Author/Authors :
Uta C. D. Kloeter، نويسنده , , Nikolaus G. Jander، نويسنده , , Peter T. Buser، نويسنده , , Stefan Osswald، نويسنده , , Jan Mueller-Brand، نويسنده , , Matthias E. Pfisterer، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2001
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Abstract :
Background: Complete revascularization of multivessel coronary artery disease (MVD) by coronary artery bypass surgery has been shown to improve outcome, but there is a lack of similar data for patients treated by angioplasty. Methods: Therefore, a consecutive series of 250 patients with MVD was separated into two groups, those with complete revascularization (n=101) and those with incomplete revascularization (n=149). Six-month ‘clinical restenosis’ rate assessed by stress myocardial perfusion scintigraphy or symptom-driven angiography and long-term 32 months outcome were compared with an equally sized group of single vessel disease (SVD) patients. Results: MVD patients with complete revascularization had a higher ‘clinical restenosis’ rate than patients with SVD (35 vs. 22%, P<0.02), although restenosis rate per treated vessel was similar (23%, 18%, P NS). If this higher early restenosis rate were accepted as ‘price’ for complete MVD angioplasty, long-term event-free survival was no longer different from that of SVD patients (86 vs. 93%, P NS). In contrast, patients with incomplete multivessel angioplasty had a significantly worse long-term outcome (22% events), especially if initially untreated, non-occluded vessels remained untreated (25% events). Conclusion: MVD angioplasty with complete revascularization has a long-term event-free survival similar to that of SVD angioplasty but at the price of a higher rate of 6-month restenosis and repeat interventions.
Keywords :
Revascularization , coronary artery disease , angioplasty
Journal title :
International Journal of Cardiology
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