Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Long-term follow-up of coronary angioplasty: the 1977–1981 national heart, lung, and blood institute registry
* Department of Medicine, Montreal Heart Institute Montreal, Quebec, Canada
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
Program Office, National Heart, Lung, and Blood Institute Bethesda, MD
Address for correspondence: Dr M. G. Bourassa. Research Centre, Montreal Heart Instsitute, 5000 Belanger Street East, Montreal, Quebec, H1T 1C8. Canada
Between September 1977 and September1981, 1587 consecutive patients underwent a first coronary angioplasty (PTCA) at 16 clinical centres. After excluding patients with prior coronary bypass surgery (CABG) and left main or minimal vessel disease, 1390 were available for in-hospital and long-term follow-up. Mean duration of follow-up was 5·9 years (range 0–9·0 years). PTCA was successful (all attempted lesions reduced 
20%) in 882 patients (63·4% and, overall, 624 patients (44·9% had complete (COREV) and 766 (55·1%) incomplete (INCOREV) revascularization or a failed PTCA. In-hospital events included death in 0·7 myocardial infarction (M1) in 5·0% and CABG in 24·0% of patients. Patients with COREV had significantly lower rates of these events than the INCOREV group. At 6 years, mortality in all registry patients was 6·5% and MI rate 15·0% CABG was performed after the initial hospitalization in 15·5% of patients and repeat PTCA in 19·1%. All events, except repeated PTCA, were less frequent in the COREV than the INCOREV group. Among patients with a successfulflrst PTCA, cumulative 6-year mortality was 5·8% and incidence of MI 10·8%; 16·9% underwent CABG and 24·7% repeat PTCA during follow-up. CABG was slightly more frequent in INCOREV than COREV patients with successful PTCA, but all other events were similar in the two groups, suggesting that INCOREV ‘by intent’ has a good prognosis. In patients with INCOREV, mortality and incidence of MI were higher during follow-up for patients with multivessel rather than single vessel disease. However, the incidence of CABG and repeat PTCA was similar in the two groups. Thus patients successfully treated by PTCA have a low event rate during follow-up (<1% annual mortality and <2% annual MI rate). However, repeat PTCA was required in 25% of patients and INCOREV led to a relatively high incidence of CABG during follow-up.
The co-investigators and institutions participating in the registry are listed in the appendix.
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