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.