Predictors of adverse outcome 10 years after coronary angioplasty

To determine which factors before percutaneous transluminal coronary angiop lasty (PTCA) predict long-term outcome, we evaluated the clinical follow-up data from 535 patients 10 years after single-vessel PTCA. Events were defi ned as death, myocardial infarction? bypass surgery or repeat PTCA, During the follow-up period 79 patients (15%) died, 59 patients (11%) suffered a m yocardial infarction, 107 patients (20%) had coronary artery bypass surgery and 141 patients (26%) underwent a redilatation, To determine the predicto rs of 10-year follow-up, 12 patient-related and 9 lesion parameters were an alyzed by logistic regression analysis. Mortality was independently increas ed in patients with diabetes, with multi-vessel disease, after a previous m yocardial infarction and in smokers. The presence of multi-vessel disease, symptoms of a higher angina class and younger age increased the risk for un dergoing bypass surgery, In the statistical model with lesion parameters, t he risk of bypass surgery was decreased if the stenosis was located in the distal segment of the coronary vessel and by a higher minimal luminal diame ter before PTCA. Conclusion. Logistic regression analysis identified multi-vessel disease, d iabetes, smoking and a previous myocardial infarction as independent clinic al predictors of an adverse outcome 10 years after coronary angioplasty. Le sion parameters before PTCA seem to be less important with regard to the lo ng-term outcome after PTCA.