LONG-TERM OUTCOME IN DOUBLE-VESSEL CORONARY-ARTERY DISEASE IN JAPANESE PATIENTS

The long-term (average: 10 years) outcome in 220 patients with double- vessel disease (DVD) treated medically was investigated. The patients underwent coronary angiography between September 1973 and February 198 4, and significant (75% or more) stenosis was detected in each of two major coronary arteries. These patients showed relatively good 5-year and 10-year survival rates of 94.5% and 87.4%, respectively. Cardiac d eath occurred in 31 patients (14.1%) and nonfatal myocardial infarctio n (MI) developed in 16 patients (7.3%) during follow-up. When these we re defined as cardiac events, the annual attrition rate was 3.1%. A co mparison of the outcome with regard to the presence or absence of MI r evealed worse results for the MI group, but no difference was observed between different sites of infarction. There was also no difference i n outcome with regard to the presence or absence of lesions in the lef t anterior descending artery (LAD). In the MI group, patients with imp aired left ventricular function (ejection fraction less than or equal to 40%) had inferior survival to those with good left ventricular func tion. Thus, DVD associated with good left ventricular function had a r elatively good outcome when treated medically, while patients with imp aired left ventricular function might benefit from revascularization.