Long-term clinical outcome after coronary balloon angioplasty - Identification of a population at low risk of recurrent events during 17 years of follow-up

被引:27
作者
van Domburg, RT
Foley, DP
de Feyter, PJ
van der Giessen, W
van den Brand, MJBM
Serruys, PM
机构
[1] Univ Hosp Rotterdam Dijkzigt, Thoraxctr, NL-3015 GD Rotterdam, Netherlands
[2] Erasmus Univ, Thoraxctr, Dept Cardiac Catheterizat & Intervent Cardiol, NL-3000 DR Rotterdam, Netherlands
关键词
PTCA; follow-up; survival; risk stratification;
D O I
10.1053/euhj.2000.2420
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims This study reports the clinical outcome, up to 17 years, of the first 856 consecutive patients treated by coronary angioplasty at a single centre and attempts to identify a subgroup of patients at low risk of adverse events. Methods and Results Follow-up status was established via hospital and general practitioner records and the civil registry. Median follow-up was 16 years. The overall 5-, 10-, 15- and 17-year survival was 90%, 78%, 64% and 58%, respectively and corresponding event-free survival was 53%, 33%, 22% and 19%. After 32% of patients had experienced a major adverse cardiac event in the first year, the annual coronary re-intervention incidence thereafter and, even beyond year 10, remained at 2%-3%. Using multivariable Cox regression, significant independent predictors of mortality were advanced age, diabetes, multivessel disease and impaired Left ventricular function at the time of PTCA. A subgroup of 26% of the patients with none of these risk factors had a survival rate similar to the general Dutch population matched for age and gender (at 5 years: 96%, at 10 years: 89% and at 15 years: 83%). Conclusion Although the majority of patients (> 80%) experienced a further cardiac event during the 17 years after their first angioplasty procedure, in those non-diabetics under 60 years with single-vessel disease and good left ventricular function, prognosis was similar to the general population. (C) 2001 The European Society of Cardiology.
引用
收藏
页码:934 / 941
页数:8
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