Study Finds Heart Patients Who Clear Some, But not All, Arteries at High Risk of Death
Contact: Catherine Herman (518) 437-4980
ALBANY, N.Y. (June 5, 2006) -- A report by University at Albany researchers has found that heart patients with multivessel blockages that are not all treated (incomplete revascularization) are at higher mortality risk than those who received treatment for all blocked arteries (complete revascularization).
The report, published in May 2006 in Circulation: the Journal of the American Heart Association, compared long-term mortality and subsequent revascularization (either by angioplasty or bypass surgery) for patients receiving stents who were completely revascularized with those who were incompletely revascularized.
"The current practice of incomplete revascularization," said Dr. Edward Hannan principal author of the study and a researcher at the University at Albany School of Public Health, "goes back to the days when the procedure was regarded as a approach just to relieve pain, and that the pain was thought to be related to just one of the narrowed arteries, which we called the culprit lesion. In other words, patients frequently receive treatment for only the artery thought to be the cause of angina (chest pain) and not all arteries that have significant blockage. What we've discovered in this study is that incomplete revascularization with stenting will have an adverse impact on life."
In the study, patients from New York State's Percutaneous Coronary Intervention Reporting System (PCIRS) were subdivided into patients who were completely revascularized and incompletely revascularized. The researchers found that 68.9 percent of all stent patients with multivessel disease who were studied were incompletely revascularized, and 30.1 percent of all patients had total occlusions and/or two or more vessels incompletely revascularized. Incompletely revascularized patients were significantly more likely to die at any time than completely revascularized patients. The authors concluded that doctors and coronary intervention patients should give consideration to either achieving complete revascularization, opting for surgery, or following coronary intervention patients' health more closely after discharge.
"The study is important," Hannan said, "because it calls into question a long-standing practice for most stent patients."View a copy of the report, Impact of Completeness of Percutaneous Coronary
Intervention Revascularization on Long-Term Outcomes in the Stent Era.