Percutaneous Transluminal Coronary Angioplasty in 1985–1986 and 1977–1981

Katherine Detre, Richard Holubkov, Sheryl Kelsey, Michael Cowley, Kenneth Kent, David Williams, Richard Myler, David Faxon, David Holmes, Martial Bourassa, Peter Block, Arthur Gosselin, Lamberto Bentivoglio, Louis Leatherman, Gerald Dorros, Spencer King, Joseph Galichia, Mahdi al-Bassam, Martin Leon, Thomas RobertsonEugene Passamani

Research output: Contribution to journalArticlepeer-review

619 Scopus citations

Abstract

In August 1985, the Percutaneous Transluminal Coronary Angioplasty Registry of the National Heart, Lung, and Blood Institute reopened at its previous sites to document changes in angioplasty strategy and outcome. The new registry entered 1802 consecutive patients who had not had a myocardial infarction in the 10 days before angioplasty. Patient selection, technical outcome, and short-term major complications were compared with those of the 1977 to 1981 registry cohort. The new-registry patients were older and had a significantly higher proportion of multivessel disease (53 vs. 25 percent, P<0.001), poor left ventricular function (19 vs. 8 percent, P<0.001), previous myocardial infarction (37 vs. 21 percent, P<0.001), and previous coronary bypass surgery (13 vs. 9 percent, P<0.01). The new-registry cohort also had more complex coronary lesions, and angioplasty attempts in these patients involved more multivessel procedures. Despite these differences, the in-hospital outcome in the new cohort was better. Angiographic success rates according to lesion increased from 67 to 88 percent (P<0.001), and overall success rates (measured as a reduction of at least 20 percent in all lesions attempted, without death, myocardial infarction, or coronary bypass surgery) increased from 61 to 78 percent (P<0.001). In-hospital mortality for the new cohort was 1 percent, and the nonfatal myocardial infarction rate was 4.3 percent. Both rates are similar to those for the old registry. The long-term efficacy of current angioplasty remains to be determined. (N Engl J Med 1988; 318:265–70.)

Original languageEnglish (US)
Pages (from-to)265-270
Number of pages6
JournalNew England Journal of Medicine
Volume318
Issue number5
DOIs
StatePublished - Feb 4 1988

ASJC Scopus subject areas

  • Medicine(all)

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