Document Detail


CABG after successful PTCA: a case-control study.
MedLine Citation:
PMID:  7771816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought characteristics predictive of the need for operative revascularization subsequent to a successful coronary angioplasty. Through June 1993, 128 patients who had successful percutaneous transluminal coronary angioplasty (PTCA) between January 1982 and March 1989 required subsequent coronary artery bypass grafting (CABG) at our hospital. These cases were matched with 128 controls who had a successful PTCA but did not require subsequent CABG. Controls were matched to cases by the date of their initial PTCA. Before initial PTCA there were no differences between the cases and controls in terms of age, sex, prior myocardial infarction, ejection fraction, duration of anginal symptoms, hypertension, hyperlipidemia, family history, or obesity (all not significant). A greater number of cases had diabetes (35 versus 18; p = 0.009). Angiography before initial PTCA revealed that cases had a greater mean number of total lesions (4.1 versus 3.3; p = 0.002) and a higher incidence of left anterior descending and circumflex artery stenoses of 70% or greater (98 versus 75 and 57 versus 34, respectively; p = 0.006). The mean number of lesions successfully dilated was greater in cases (2.4 versus 1.7; p = 0.0001). Cases had CABG at a mean interval of 16.7 +/- 23 months. There were 17 late deaths among cases and 9 among the controls at a mean of 38.6 +/- 30 months. The survival probability at 5 years was 94.5% for controls and 87.9% for cases (p = 0.048). Initial revascularization by PTCA is followed by CABG at a brief interval in a subset of patients who have markers of more severe disease than do patients who do not require early CABG.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R G Johnson; C Sirois; J F Watkins; R L Thurer; F W Sellke; W E Cohn; R E Kuntz; R M Weintraub
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  59     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-07-06     Completed Date:  1995-07-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1391-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Beth Israel Hospital, Boston, MA 02215, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / economics
Case-Control Studies
Coronary Artery Bypass* / economics
Coronary Disease / therapy*
Fees and Charges
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Recurrence
Severity of Illness Index
Survival Analysis
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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