CLINICAL OUTCOMES AFTER SUCCESSFUL PERCUTANEOUS CORONARY ANGIOPLASTY OF SAPHENOUS-VEIN GRAFT DISEASE AND THE IMPORTANCE OF LONG-TERM ASSESSMENT

We examined the short- and long-term outcome of 327 patients at Mayo C linic who had undergone coronary angioplasty of saphenous vein graft s tenoses to determine whether the traditional 6-month assessment of cli nical end points after coronary angioplasty is as useful as it is for patients who have had angioplasty of native vessel disease. Follow-up over 3.3+/-2.7 years was performed. At 6 months, 96+/-1% of the patien ts were alive, whereas at the 1- and 5-year end points, survival had d eteriorated to 92+/-2 and 67+/-3%, respectively. Only 80+/-2% were fre e of severe angina at 6 months and 62+/-3 and 36+/-3% after 1 and 5 ye ars. Combined event-free rate for death, Q-wave myocardial infarction or repeat coronary artery bypass surgery was 86+/-2% at 6 months, 78+/ -2% at 1 year: and 45+/-4% at 5 years. Independent predictors of morta lity included advancing age, diabetes mellitus, target vein grafts >5 years old and left ventricular ejection fraction <40%. In conclusion, despite reasonable 6- to 12-month outcomes following vein graft angiop lasty, significant attrition in survival and event-free survival was o bserved. These observations have important implications for the interp retation of results of trials comparing conventional angioplasty and c oronary bypass surgery with newer interventional devices if only the t raditional 6-month follow-up interval is used. (C) 1998 Published by E lsevier Science Ireland Ltd.