August 17, 2026European Heart Journal
Long-term follow-up of coronary angioplasty: the 1977-1981 national heart, lung, and blood institute registry
Key result
Complete revascularization during first angioplasty is linked to lower death, MI, and CABG versus incomplete revascularization.
- n=1,390
Why the study?
Does complete revascularization via first PTCA improve long-term clinical outcomes compared to incomplete revascularization or failed PTCA?
Population
1390 patients undergoing a first PTCA without prior CABG, left main, or minimal vessel disease
Comparison
Complete revascularization (COREV) vs incomplete revascularization (INCOREV) or failed PTCA
Design
Multicentre registry cohort study
Follow-up
Mean 5.9 years (range 0-9.0 years)
Authors
Discussion
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Implication
Early PTCA registry outcomes benchmark historical success; leaves open comparative durability versus modern revascularization strategies.
Key Points
- To determine the in-hospital and long-term clinical outcomes over up to 9 years in patients undergoing their first percutaneous transluminal coronary angioplasty.
- Analyzed 1,390 consecutive patients undergoing a first PTCA across 16 clinical centres between September 1977 and September 1981, excluding individuals with prior CABG or left main/minimal disease.
- Tracked patients for a mean follow-up duration of 5.9 years (range 0–9.0 years) to evaluate mortality, myocardial infarction, repeat PTCA, and subsequent CABG across complete versus incomplete revascularization groups.
- Initial PTCA was successful in 63.4% (882/1390) of patients; in-hospital mortality was 0.7%, myocardial infarction occurred in 5.0%, and CABG was required in 24.0%, with significantly lower event rates in complete versus incomplete revascularization.
- At 6-year follow-up across all registry patients, cumulative mortality was 6.5%, myocardial infarction rate was 15.0%, subsequent CABG occurred in 15.5%, and repeat PTCA was performed in 19.1%.
- Among patients with a successful first PTCA, 6-year cumulative mortality was 5.8% and myocardial infarction incidence was 10.8%, with similar event rates between complete and planned incomplete revascularization aside from slightly higher CABG rates.
Study Design
Type
Cohort (n=1,390)
Multicenter
Yes
Structured PICO
Does complete revascularization via first PTCA improve long-term clinical outcomes compared to incomplete revascularization or failed PTCA?
P
Population
1,390 patients undergoing a first coronary angioplasty without prior CABG or left main disease, followed for a mean of 5.9 years.
E
Exposure
Complete revascularization (COREV) via first coronary angioplasty (PTCA)
C
Comparator
Incomplete revascularization (INCOREV) or failed PTCA
O
Outcome
In-hospital and long-term (6-year) mortality, myocardial infarction (MI), CABG, and repeat PTCAhard clinical
Complete revascularization during first PTCA is associated with lower rates of long-term mortality, MI, and CABG compared to incomplete revascularization or failed PTCA.
Cite This Study
Bourassa et al. (1989) conducted a cohort in Coronary artery disease (n=1,390). Complete revascularization (COREV) vs. Incomplete revascularization (INCOREV) or failed PTCA was evaluated on In-hospital and long-term events (death, MI, CABG, repeat PTCA). Complete revascularization during a first coronary angioplasty was associated with significantly lower rates of in-hospital and long-term death, MI, and CABG compared to incomplete revascularization.