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European Heart Journal 2001 22(11):934-941; doi:10.1053/euhj.2000.2420
Copyright © 2001 by the European Society of Cardiology.
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Long-term clinical outcome after coronary balloon angioplasty. Identification of a population at low risk of recurrent events during 17 years of follow-up

R.T van Domburgf1, D.P Foley, P.J de Feyter, W van der Giessen, M.J.B.M van den Brand and P.W Serruys

The Department of Cardiac Catheterization and Interventional Cardiology, Thoraxcenter, Erasmus University and University Hospital Dijkzigt Rotterdam, The Netherlands

revised August 20, 2000; accepted August 23, 2000

Abstract

Aims This study reports the clinical outcome, up to 17 years, of the first 856 consecutive patients treated by coronary angioplasty at a single centre and attempts to identify a subgroup of patients at low risk of adverse events.

Methods and Results Follow-up status was established via hospital and general practitioner records and the civil registry. Median follow-up was 16 years. The overall 5-, 10-, 15- and 17-year survival was 90%, 78%, 64% and 58%, respectively and corresponding event-free survival was 53%, 33%, 22% and 19%. After 32% of patients had experienced a major adverse cardiac event in the first year, the annual coronary re-intervention incidence thereafter and, even beyond year 10, remained at 2%–3%. Using multivariable Cox regression, significant independent predictors of mortality were advanced age, diabetes, multivessel disease and impaired left ventricular function at the time of PTCA. A subgroup of 26% of the patients with none of these risk factors had a survival rate similar to the general Dutch population matched for age and gender (at 5 years: 96%, at 10 years: 89% and at 15 years: 83%).

Conclusion Although the majority of patients (>80%) experienced a further cardiac event during the 17 years after their first angioplasty procedure, in those non-diabetics under 60 years with single-vessel disease and good left ventricular function, prognosis was similar to the general population.

Key Words: PTCA, follow-up, survival, risk stratification

f1 Correspondence: Ron T. van Domburg, University Hospital Rotterdam Dijkzigt, Thoraxcenter, Location 5 Midden, Room H 539, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.

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