Evaluating the long-term outcomes of angioplasty for patients with coronary heart disease

This study compared the long-term outcomes of different coronary angioplasty procedures in patients with coronary heart disease (CHD). The authors found that staged CA was better at reducing the risk of complications compared to culprit CA.

CHD is caused by the narrowing of blood vessels that supply the heart (coronary arteries). This can lead to complications, including heart attacks. CHD is often treated with a procedure called coronary angioplasty (CA). In this procedure, a small tube is inserted into the affected blood vessel to help widen it.

There are two types of CA procedures. Culprit CA is done in the affected blood vessel only. Staged CA is done in the affected blood vessel and surrounding blood vessels, so it requires more surgery than culprit CA. The long-term outcomes of staged CA versus culprit CA in patients with CHD remain under investigation.

This study included the medical records of 1,205 patients with CHD who received a CA procedure. 629 patients had culprit CA, and 576 patients had staged CA. Patients were followed-up for an average of 5.01 years. Long-term complications were evaluated, including heart attack, stroke, any additional CA procedures, and mortality due to CHD.

Overall, patients who had staged CA had a 28% lower risk of long-term complications compared to patients who had culprit CA. Patients who received staged CA had a 48% lower risk of a heart attack and a 26% lower risk of needing more CA procedures. 

Staged CA was significantly associated with lower risks for heart attack (51%) and needing more CA procedures (33%). However, patients with diabetes who received staged CA had similar risks of these complications compared to patients who had culprit CA.

This study concluded that staged CA is better at preventing long-term complications of CHD than culprit CA. However, patients with diabetes did not experience this reduced risk. The authors suggest that more studies are needed for these patients.

This study analyzed medical records retrospectively. Also, this study involved Chinese patients only, so these results may not apply to all patients. During the study period, CA technology and medications were updated. More studies are needed to confirm these results.

Talk to your doctor about the advantages and risks of coronary angioplasty.