LONG-TERM (10-YEAR) OUTCOME IN PATIENTS WITH UNSTABLE ANGINA-PECTORISTREATED BY CORONARY BALLOON ANGIOPLASTY

Citation
Da. Halon et al., LONG-TERM (10-YEAR) OUTCOME IN PATIENTS WITH UNSTABLE ANGINA-PECTORISTREATED BY CORONARY BALLOON ANGIOPLASTY, Journal of the American College of Cardiology, 32(6), 1998, pp. 1603-1609
Citations number
52
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
07351097
Volume
32
Issue
6
Year of publication
1998
Pages
1603 - 1609
Database
ISI
SICI code
0735-1097(1998)32:6<1603:L(OIPW>2.0.ZU;2-4
Abstract
Objectives. We sought to examine completed 10-year survival and event- free survival in patients with stable and unstable angina pectoris tre ated by coronary balloon angioplasty. Background. Patients with unstab le angina are at increased risk for recurrent acute coronary events. M ethods. The study included 208 consecutive patients (133 with stable a nd 75 with unstable angina pectoris) undergoing angioplasty from 1984 to 1986. The balloon crossed the lesion in 185 patients (121 with stab le and 64 with unstable angina pectoris). Angioplasty was performed in patients with unstable angina pectoris 12 +/- 15 days (median 8) afte r symptom onset. Patients with unstable angina pectoris were classifie d retrospectively into Braunwald class I (n = 3), class II (n = 20), c lass III (n = 28), class B (n = 52) and class C (n = 12). Follow-up da ta were obtained from hospital charts, telephone interview and officia l death certificates where applicable. The study had >80% power to det ect a clinically significant 20% difference in survival and a 20% diff erence in event-free survival between the stable and unstable patient groups. Results. Despite similar baseline characteristics, early (40-d ay) mortality was slightly higher in patients with unstable angina (4. 7% [3 of 64 patients] vs. 0.8% [1 of 121 patients], p = NS). Long-term outcome,vas not different, because survival curves were parallel ther eafter (10-year survival was 83% for those with stable and 77% for tho se with unstable angina, p = NS). Survival free of myocardial infarcti on or coronary artery bypass graft surgery at 10 years was 53% in pati ents with stable and 47% in patients with unstable angina (p = NS), an d survival free of infarction, bypass surgery or repeat angioplasty wa s 32% for both groups at 10 years. In patients with Braunwald class II I unstable angina, 10-year sunival was 80%, as compared with 85% in ot her patients with unstable angina, due to the early hazard (p = NS). S urvival and event-free survival were similar in patients who had had a recent myocardial infarction (Braunwald class C) and in patients with acute electrocardiographic changes. Repeat hospital admissions were n ot more frequent in patients with unstable angina (3.1 +/- 3.5 vs. 3.0 +/- 2.6, p = NS). Conclusions. Ten-year survival and event-free survi val were similar in patients with stable and unstable angina pectoris treated by coronary balloon angioplasty, with no evidence of an increa sed rate of recurrent cardiovascular events in the unstable group. (J Am Coll Cardiol 1998;32:1603-9) (C)1998 by the American College of Car diology.