Percutaneous coronary intervention in 1997-1998 resulted in lower rates of in-hospital death, MI, and emergency CABG compared with 1985-1986 (4.9% vs 7.9%; P=0.001), despite more complex disease.
Observational (n=3,990)
Yes
Absolute Event Rate: 4.9% vs 7.9%
p-value: p==0.001
BACKGROUND: Although refinements have occurred in coronary angioplasty over the past decade, little is known about whether these changes have affected outcomes. METHODS AND RESULTS: Baseline features and in-hospital and 1-year outcomes of 1559 consecutive patients in the 1997-1998 Dynamic Registry who were having first coronary intervention were compared with 2431 patients in the 1985-1986 National Heart, Lung, and Blood Institute Registry. Compared with patients in the 1985-1986 Registry, Dynamic Registry patients were older (mean age, 62 versus 58 years; P:<0.001) and more often female (32.1% versus 25.5%; P:<0.001). In the Dynamic Registry, procedures were more often performed for acute myocardial infarction (22.9% versus 9.9%; P:<0.001) and treated lesions were more severe (84.5% versus 82.5% diameter reduction; P:<0.001), thrombotic (22.1% versus 11.3%; P:<0.001) or calcified (29.5% versus 10.8%; P:<0.001). Stents were used in 70.5% of Dynamic Registry patients, whereas 1985-1986 patients received balloon angioplasty alone. Procedural success was higher in the Dynamic Registry (92.0% versus 81.8%; P:<0.001) and the rate of in-hospital death, myocardial infarction, and emergency coronary bypass surgery combined was lower (4.9% versus 7.9%; P:=0.001) than in the 1985-1986 Registry. The 1-year rate for CABG was lower in the Dynamic Registry (6.9% versus 12.6%; P:<0.001). CONCLUSIONS: Although Dynamic Registry patients had more unstable and complex coronary disease than those in the 1985-1986 Registry, their rate of procedural success was higher whereas rates of complications and subsequent CABG were lower. Results of percutaneous coronary intervention have improved substantially over the past decade.
Williams et al. (Tue,) conducted a observational in Coronary artery disease requiring first coronary intervention (n=3,990). Percutaneous coronary intervention in 1997-1998 vs. Percutaneous coronary intervention in 1985-1986 was evaluated on In-hospital death, myocardial infarction, and emergency coronary bypass surgery combined (p==0.001). Percutaneous coronary intervention in 1997-1998 resulted in lower rates of in-hospital death, MI, and emergency CABG compared with 1985-1986 (4.9% vs 7.9%; P=0.001), despite more complex disease.