Predictors of Successful Percutaneous Transluminal Coronary Angioplasty in Multivessel Disease

ABSTRACT

BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) was initially applied in patients with proximal, discrete, single vessel disease, but complex multivessel PTCA has become feasible with increased operator experience and instrumental development. The authors analyzed the predictive factors concerning the success rate of multivessel PTCA. METHODS: To evaluate the predictive factors of the successful PTCA in multivessel disease, clinical and angiographic findings of 39 patients (male 31, female 8, age 58.4 9.9) with 84 multiple lesions, who admitted to Chonnam National University Hospital between January 1991 and December 1992, were analyzed. RESULTS: Overall success rate of 84 attempted lesions was 92.9%. Success rate of old aged group 65 years or older was 89.5% and that of below 65 years was 93.8%. Success rate in acute myocardial infarction was 80% and significantly lower than those of old myocardial infarction, unstable and stable angina. Success rate of AHA type C lesion was 75.0% and significantly lower than those of type A(100%), type B1(96.7%) and type B2(95.2%). Success rate according to target vessels was not significantly different. Angiographic findings including calcification, lesion length, angulation, TIMI flow grade, left ventricular function and left ventricular aneurysm didn't affect the success rate of multivessel PTCA significantly. CONCLUSION: Overall success rate of multivessel PTCA was 92.9%. The negative predictive factors affecting the success rate of multivessel PTCA were the acute myocardial infarction out of clinical factors and the AHA type C lesion out of angiographic factors.