Ten-year outcome after coronary angioplasty in patients with single vesselcoronary artery disease and comparison with the results of the coronary artery surgery study (CASS)

The 10-year results of randomized trials comparing percutaneous translumina l coronary angioplasty (PTCA) in patients with single-vessel coronary arter y disease (CAD) with coronary artery bypass grafting (CABG) and medical tre atment are not available yet. The aim of this evaluation was to compare our 10-year follow-up results after PTCA in patients with single-vessel CAD wi th the 10-year follow-up results after CABG and medical treatment in the Co ronary Artery Surgery Study (CASS) trial. We evaluated the clinical outcome of 509 patients with single-vessel CAD 10 years after coronary angioplasty , The data were compared with the results of 214 patients with single-vesse l CAD after CABG or medical treatment from the CASS trial. End points were defined as death and myocardial infarction. Statistical evaluation was perf ormed by life-table analysis and 2-sided Fisher's exact test. The rate of s urvival was 86% 10 years after PTCA compared with 85% after CABG and 82% af ter medical treatment in patients from the CASS trial (p = NS). Survival fr ee from myocardial infarction was 77% after coronary angioplasty, 70% after CABG, and 72% after medical treatment (p = NS), Thus, in patients with sin gle-vessel CAD, infarct-free survival 10 years after coronary angioplasty c ompared favorably with the results after bypass surgery or medical treatmen t from the CASS trial. (C)2000 by Excerpta Medica, Inc.