Percutane transluminale coronairangioplastiek in 1980/'85 en in 1995/'96: vaker meervatslijden, minder heringrepen en ongewijzigde sterfte 1 en 5 jaar na de ingreep

To describe the characteristics of patients undergoing coronary angioplasty (PTCA) over the past 20 years and the outcome after 1 and 5 years.

Design

Prospective follow-up study.

Methods

All patients who underwent a first PTCA in the Thorax centre of the Erasmus Medical Centre in Rotterdam during the period from 1 September 1980 through 30 November 1985 (group I) were compared with all patients who likewise underwent such a first PTCA during the period between 1 September 1995 and 31 December 1996 (group II). Data on the patients, the operations, any reoperations and the mortality were obtained from patient records, general practitioners and municipal archives. Cumulative percentages of survival and of not having rePTCA or coronary artery bypass surgery (CABG) were analysed by using the Kaplan-Meier-method.

Results

Group I consisted of 856 patients and group II of 840 patients. The percentage of males decreased over the years from 80 to 69. The average age increased from 56 to 60 years; the oldest patient in group I was 75 years and the oldest in group II was 87 years. The percentage of patients with multivessel disease increased from 36 to 44. Stent implantation occurred in 55 of the patients in group II (0 in group I). The necessity for urgent CABG due to unsuccessful PTCA decreased from 9.4 to 1. After 1 year, the percentage of coronary revascularisations was 28.8 in group I and 22.6 in group II (p = 0.01). The perioperative mortality and the 5-year survival were not significantly different in the two groups (group I: 1.3 and 90; group II: 2.4 and 88, respectively). For both groups, higher age, a smaller ejection fraction, more extensive vascular disease and no treatment with statins were independent predictors of a higher mortality after 5 years. In group II, renal function disorders were the most important predictor of higher mortality.