SHORT-TERM AND LONG-TERM OUTCOME AFTER PTCA IN PATIENTS WITH STABLE AND UNSTABLE ANGINA

Acute results and follow-up data over a period of 36 months after attempted PTCA in 406 patients with stable angina and 202 patients with unstable angina are reported. The rate of acute complications (death, myocardial infarction and bypass grafting (CABG) amounted to 1.5% in stable and 6.4% in unstable patients (P<0.005). Within the first week after PTCA a significantly lower percentage (1.7% vs 10.4%) of cardiac events (death, myocardial infarction. CABG and repeat PTCA) was observed in the stable group (P<0.001), During a 12-month follow-up period, another 16.3% of the patients in the stable group and 30.7% of unstable patients suffered a new cardiac event (P<0.001). The long-term follow-up of 36 months revealed no significant difference in the event rate between stable and unstable patients (5.4% in both groups). The cumulative rate of myocardial infarction within 3 years after PTCA was significantly lower (3.7% vs 9.4%) in the stable group (P<0.005). The cumulative mortality amounted to 3.0% in stable and 6.4% in unstable patients (P<0.05) and the incidence of repeated PTCA was 8.1% and 19.3% respectively (P<0.001). The crossover rate to CABG was 10.1% in stable and 17.8% in unstable patients (P < 0.01). The total rate of any cardiac event thus amounted to 24.9% in stable and 53.0% in unstable patients (P<0.001) within a 3-year follow-up period. At the end of follow-up, 74% of the stable patients were asymptomatic, compared with 60% of unstable patients (P<0.01). 45% of the stable group patients and 28% of the unstable patients were not on antianginal treatment (P<0.01). We conclude that PTCA in unstable angina carries a markedly enhanced risk of acute complications and cardiac events in the early phase after PTCA. In the long run, patients with stable angina have a better quality of life with regard to medical treatment and angina symptoms. © 1990 The European Society of Cardiology.