Value of visual versus central quantitative measurements of angiographic success after percutaneous transluminal coronary angioplasty

David P. Faxon, Robert Vogel, Wanlin Yeh, David R. Holmes, Katherine Detre

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

This study examined the optimal angiographic definition for long-term success after angioplasty and compared visual and quantitative angiographic measurements in assessing outcome. The National Heart, Lung, and Blood Institutes-Percutaneous Transluminal Coronary Angioplasty Registry prospectively followed 1,768 patients from 15 clinical centers. Symptom-free survival, defined as survival without angina, myocardial infarction, bypass surgery, or death, occurred in 59% of patients. In a subset of 393 patients, quantitative coronary angiography (QCA), done at a core angiographic laboratory, was compared with visual site readings. Although there was considerably more variability for visual readings, a site reading of a change in percent stenosis of >20% correlated highly with symptom-free survival (64.6% for patients who had all lesions successfully dilated, 48% for patients with partial success, and only 21% for patients without angiographic success; p < 0.001). Similar findings were seen for other angiographic definitions, but a change of >20% was most discriminatory. In contrast, QCA readings had little or no predictive value. This study confirms that visual assessment of the immediate change in percent stenosis is predictive of a successful 1-year outcome. A change of greater than 20% is most discriminatory and should still be used to define angiographic success. QCA does not appear to be superior to visual assessment in predicting 1-year outcome.

Original languageEnglish (US)
Pages (from-to)1067-1072
Number of pages6
JournalAmerican Journal of Cardiology
Volume77
Issue number12
DOIs
StatePublished - May 15 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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