PROGNOSIS AND PREDICTIVE FACTORS OF MORTA LITY IN INOPERABLE CORONARY-ARTERY DISEASE

In the period between September 1979 and December 1986, 105 out of 217 8 consecutive patients with coronary artery disease (men 93, women 12; age : 58.1 +/- 10 years; previous/ myocardial infarction : 67 %) wer e considered inoperable because of poor distal coronary circulation (8 4.8 %), left ventricular dysfunction (3.8 %) or both (11.4 %). Fifty-f our clinical, ergometric and angiographic parameters were examined at inclusion. The mean follow-up was 69 +/- 40.2 months (1 to 146 months) . The Kaplan Meier 10 year survival rate was 43 %. Only 25 % of the po pulation remained free of major cardiac events. Multivariate analysis showed that only the coronary angiographic score had a significant pre dictive value. The authors conclude that the long-term prognosis of th ese patients is poor. Some did undergo coronary bypass surgery seconda rily, and their prognosis was good, suggesting that revascularisation, even if only partial and at high risk, should be considered.