Acute coronary events associated with percutaneous transluminal coronary angioplasty |
| |
Authors: | Michael J Cowley MD Gerald Dorros MD Sheryl F Kelsey PhD Mark Van Raden MA Katherine M Detre MD DrPH |
| |
Institution: | From the Department of Medicine, Division of Cardiology, Medical College of Virginia, Richmond, Virginia, USA |
| |
Abstract: | Acute coronary events reported in patients enrolled in the NHLBI PTCA Registry were analyzed. Data were collected on 3,079 patients from 105 contributing centers. Coronary vascular events (dissection, occlusion, spasm, embolism, perforation or rupture) or ischemic events (MI or prolonged angina) occurred in 418 patients (13.6%). Major complications (MI), emergency surgery or death) occurred in 280 patients (67%) with acute coronary events. The most frequent events were prolonged angina, which occurred in 211 (6.8%), and MI, in 170 (5.5%). Coronary dissection, occlusion and spasm each occurred in approximately 5% of patients. Coronary embolism, perforation and rupture were rare (< 0.2% for each). Dissection and occlusion each had a high frequency (> 80%) of associated major complications. A substantially lower incidence of major complications occurred in patients with isolated coronary spasm (18%) or prolonged angina (35%). Clinical and angiographic predictors for overall and specific events were identified. Coronary events occurred more frequently in women and patients with unstable angina. Eccentric lesions were associated with a higher rate of coronary events, and event rates were lower with single discrete lesions than with other types of lesions. The frequency of any coronary event, MI, prolonged angina and coronary spasm each decreased with increasing experience with PTCA. The frequency of dissection and occlusion did not change with experience. |
| |
Keywords: | Address for reprints: Michael J Cowley MD Box 59 MCV Station Richmond Virginia 23298 |
本文献已被 ScienceDirect 等数据库收录! |
|