Prognostic heterogeneity among patients with chronic stable coronary disease: determinants of long-term mortality after treatment with percutaneous intervention

• Published in: EuroIntervention Vol. 5; no. 2; pp. 239 - 243
• Main Authors: LEMOS, Pedro A, CAMPOS, Carlos A. H, SPADARO, Andre G, MARTINEZ, Eulógia E, FAICAO, Joao L. A. A, RIBEIRO, Expedito E, PERIN, Marco A, KAJITA, Luiz J, ESTEVES, Antonio, DA GAMA, Marcus N, HORTA, Pedro E, MARCHIORI, Gilberto G
• Format: Journal Article
• Language: English
• Published: Toulouse Société Europa Edition 01-06-2009
• Subjects: Aged; Angioplasty, Balloon, Coronary - mortality; Biological and medical sciences; Brazil - epidemiology; Cardiology. Vascular system; Chronic Disease; Coronary Disease - mortality; Coronary Disease - therapy; Coronary heart disease; Diseases of the cardiovascular system; Female; Heart; Hospital Mortality; Humans; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Patient Discharge; Proportional Hazards Models; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Risk Assessment; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Treatment Outcome; Brazil; Human; Endoprosthesis; Prognosis; Angioplasty; Chronic disease; Determinant; Mortality; Instrumentation therapy; Cardiovascular disease; Patient; Instrumental dilatation; Metal; Coronary heart disease; Epidemiology; Long term; Stent; Percutaneous route; Heterogeneity; bare metal stent
• ISSN: 1774-024X; 1969-6213
• DOI: 10.4244/EIJV5I2A37

To evaluate the risk and predictors of death in a large population of patients with stable coronary disease treated with percutaneous intervention.
The study population comprised 1,276 patients with chronic angina or silent ischaemia who underwent elective coronary angioplasty. Baseline and in-hospital mortality data were prospectively collected for all patients during the index hospitalisation. Post-discharge outcome was assessed at out-patient clinic, by review of the patients' records, or direct phone contact. Deaths were classified as cardiac and non-cardiac. Age, peripheral arterial disease, congestive heart failure with NYHA class >or= III, triple-vessel disease, and procedural success (i.e. angiographic success for all lesions in the absence of peri-procedural infarction) remained as multivariate independent predictors of death. For the entire population 4-year cumulative all-cause and cardiac mortality were respectively 5.4% and 4.1%. Four-year mortality for patients without any multivariate predictor was 2.4%, while for patients with two or more predictors the death rate was 16.3% after four years.
Patients with stable coronary disease undergoing percutaneous treatment have an overall low mortality rate after four years. Nevertheless, stable patients comprise a heterogeneous population in terms of risk profile, ranging from patients at very low risk of late death to individuals with a poor long-term prognosis.