BACKGROUND: Complete revascularization of multivessel coronary artery disease (MVD) by coronary artery bypass surgery has been shown to improve outcome, but there is a lack of similar data for patients treated by angioplasty. METHODS: Therefore, a consecutive series of 250 patients with MVD was separated into two groups, those with complete revascularization (n=101) and those with incomplete revascularization (n=149). Six-month 'clinical restenosis' rate assessed by stress myocardial perfusion scintigraphy or symptom-driven angiography and long-term 32 months outcome were compared with an equally sized group of single vessel disease (SVD) patients. RESULTS: MVD patients with complete revascularization had a higher 'clinical restenosis' rate than patients with SVD (35 vs. 22%, P<0.02), although restenosis rate per treated vessel was similar (23%, 18%, P NS). If this higher early restenosis rate were accepted as 'price' for complete MVD angioplasty, long-term event-free survival was no longer different from that of SVD patients (86 vs. 93%, P NS). In contrast, patients with incomplete multivessel angioplasty had a significantly worse long-term outcome (22% events), especially if initially untreated, non-occluded vessels remained untreated (25% events). CONCLUSION: MVD angioplasty with complete revascularization has a long-term event-free survival similar to that of SVD angioplasty but at the price of a higher rate of 6-month restenosis and repeat interventions.
BACKGROUND: Complete revascularization of multivessel coronary artery disease (MVD) by coronary artery bypass surgery has been shown to improve outcome, but there is a lack of similar data for patients treated by angioplasty. METHODS: Therefore, a consecutive series of 250 patients with MVD was separated into two groups, those with complete revascularization (n=101) and those with incomplete revascularization (n=149). Six-month 'clinical restenosis' rate assessed by stress myocardial perfusion scintigraphy or symptom-driven angiography and long-term 32 months outcome were compared with an equally sized group of single vessel disease (SVD) patients. RESULTS:MVDpatients with complete revascularization had a higher 'clinical restenosis' rate than patients with SVD (35 vs. 22%, P<0.02), although restenosis rate per treated vessel was similar (23%, 18%, P NS). If this higher early restenosis rate were accepted as 'price' for complete MVD angioplasty, long-term event-free survival was no longer different from that of SVDpatients (86 vs. 93%, P NS). In contrast, patients with incomplete multivessel angioplasty had a significantly worse long-term outcome (22% events), especially if initially untreated, non-occluded vessels remained untreated (25% events). CONCLUSION:MVD angioplasty with complete revascularization has a long-term event-free survival similar to that of SVD angioplasty but at the price of a higher rate of 6-month restenosis and repeat interventions.
Authors: Philippe Généreux; Tullio Palmerini; Adriano Caixeta; Gregg Rosner; Philip Green; Ovidiu Dressler; Ke Xu; Helen Parise; Roxana Mehran; Patrick W Serruys; Gregg W Stone Journal: J Am Coll Cardiol Date: 2012-04-04 Impact factor: 24.094
Authors: M B Nienhuis; J P Ottervanger; J-H E Dambrink; L D Dikkeschei; H Suryapranata; A W J van 't Hof; J C A Hoorntje; M J de Boer; A T M Gosselink; F Zijlstra Journal: Neth Heart J Date: 2007-05 Impact factor: 2.380
Authors: Vinayak Nagaraja; Sze-Yuan Ooi; James Nolan; Adrian Large; Mark De Belder; Peter Ludman; Rodrigo Bagur; Nick Curzen; Takashi Matsukage; Fuminobu Yoshimachi; Chun Shing Kwok; Colin Berry; Mamas A Mamas Journal: J Am Heart Assoc Date: 2016-12-16 Impact factor: 5.501