TY - JOUR
T1 - Percutaneous Transluminal Coronary Angioplasty in 1985–1986 and 1977–1981
AU - Detre, Katherine
AU - Holubkov, Richard
AU - Kelsey, Sheryl
AU - Cowley, Michael
AU - Kent, Kenneth
AU - Williams, David
AU - Myler, Richard
AU - Faxon, David
AU - Holmes, David
AU - Bourassa, Martial
AU - Block, Peter
AU - Gosselin, Arthur
AU - Bentivoglio, Lamberto
AU - Leatherman, Louis
AU - Dorros, Gerald
AU - King, Spencer
AU - Galichia, Joseph
AU - al-Bassam, Mahdi
AU - Leon, Martin
AU - Robertson, Thomas
AU - Passamani, Eugene
PY - 1988/2/4
Y1 - 1988/2/4
N2 - 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.)
AB - 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.)
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U2 - 10.1056/NEJM198802043180501
DO - 10.1056/NEJM198802043180501
M3 - Article
C2 - 2961993
AN - SCOPUS:0023830815
SN - 0028-4793
VL - 318
SP - 265
EP - 270
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 5
ER -