Results of Interventional Treatment of Stress Positive Coronary Artery Disease
| Autor: | Rainer Hoffmann, Wael Alrawashdeh, Bader Almutairi, Wolfgang Schäfer, Umar Adamu, Verena Deserno, E. Kleinhans, Daniela Knollmann |
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| Rok vydání: | 2010 |
| Předmět: |
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medicine.medical_specialty medicine.medical_treatment Adrenergic beta-Antagonists Coronary Artery Disease Coronary Angiography Revascularization Angina Coronary artery disease Surveys and Questionnaires Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Angioplasty Balloon Coronary Aged Retrospective Studies Tomography Emission-Computed Single-Photon Nitrates business.industry Percutaneous coronary intervention Drug-Eluting Stents Retrospective cohort study Canadian Cardiovascular Society Middle Aged Prognosis medicine.disease Survival Analysis Surgery Conventional PCI Exercise Test Cardiology Drug Therapy Combination Female Stents Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 105:1535-1539 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2010.01.010 |
| Popis: | The aim of this study was to define the impact of percutaneous coronary intervention (PCI) including stenting in patients with stress-positive stable coronary artery disease on long-term prognosis and symptoms. A group of 1,018 patients were identified from the angiographic and single-photon emission computed tomographic (SPECT) databases (technetium-99m sestamibi or tetrofosmin at rest and during stress) January 1, 2000, to December 31, 2003, to have significant coronary artery disease (50% diameter stenosis on quantitative coronary angiography) and positive SPECT findings. Two hundred sixty-six patients were medically treated. Seven hundred fifty-two patients with positive SPECT findings who underwent PCI were matched to 266 patients of similar age, gender, number and location of stenotic arteries, left ventricular function, and size of SPECT perfusion defect who underwent medical treatment. Clinical events (death, nonfatal myocardial infarction, and revascularization) as well as clinical symptoms (angina or dyspnea, Canadian Cardiovascular Society class II to IV) were determined after a follow-up period of 6.4 +/- 1.2 years. In 524 of the 532 patients (98%), clinical follow-up was obtained. There were no differences between the PCI and medical groups in the frequencies of death (13.5% vs 10.9%) and myocardial infarction (5.3% vs 5.6%) during follow-up. PCI patients had more revascularization procedures1 year after choice of treatment modality (14.7% vs 6.0%, p0.002). During the subsequent follow-up period (1 year), the 2 groups did not differ in the frequency of revascularization procedures. At the end of follow-up, patients in the PCI group complained less frequently of angina pectoris (38% vs 49%, p = 0.014). In conclusion, in patients with stress-positive stable coronary artery disease, PCI including stenting did not reduce mortality or rate of nonfatal myocardial infarction. The PCI group complained less frequently of angina pectoris at long-term follow-up. |
| Databáze: | OpenAIRE |
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