Comparison of immediate and one-year outcome after coronary angioplasty ofnarrowing < 3 mm with those >= 3 mm (The National Heart, Lung, and Blood Institute Dynamic Registry)

Balloon angioplasty of small coronary artery lesions has been associated wi th lower success and higher complication rates than large coronary artery l esions. This study evaluates the in-hospital and 1-year outcome of the trea tment of small coronary artery lesions in the modern era of interventional cardiology and compares it with the outcome of treating large coronary arte ry lesions. Of 1,658 patients with a single lesion treated from July 1997 t o February 1998 in the National Heart, Lung, and Blood Institute (NHLBI) Dy namic Registry, there were 587 patients with small coronary artery lesions (<3 mm) and 1,071 patients with large coronary artery lesions (<greater tha n or equal to>3 mm). Success, in-hospital, and 1-year outcomes between both groups were compared. Patients with lesions in small coronary arteries wer e more often women, insulin-treated diabetics, and had undergone more prior coronary bypass graft surgery. Conventional angioplasty alone was performe d more often and angioplasty with stents was performed less often in the sm all coronary artery than in the large coronary artery group. Angiographic s uccess was slightly lower in the small coronary artery group (94.2% vs 96.9 %, p <0.05). Periprocedural and in-hospital complication rates were similar in both groups. likewise, at I-year follow-up, major adverse cardiac event s including death, myocardial infarction, and coronary artery bypass graft surgery were relatively low and comparable between the 2 groups, although p atients with small coronary arteries were more likely to undergo repeat rev ascularization (17.4% vs 13.6%, p <0.05). Treatment of lesions in small cor onary arteries in the modern era is associated with high success and low co mplication rates, comparable to the treatment of large coronary artery lesi ons, although the incidence of repeat revascularization was significantly g reater at follow-up even if stents were used. (C) 2001 by Excerpta Medica, Inc.