Coronary Angioplasty Complications in 505 Cases and Their Predictors

Between October 1988-January 1991, PTCA procedure was performed in 505 patients (604 stenoses). Average age was 51±7 years. There were 436 men (86 %) and 69 women (14 %). Angiographically, 304 patients (60 %) had single-vessel disease, 145 patients (29 %) two-vessel disease and 56 patients (11 %) had theree-vessel disease. Ejection fraction was higher than 50 % in 485 (96 %) patients. Minor complication rate was 15.4 %. Major ischemic complications occurred in 31 cases (6.1 %), of which nonfatal myocardial infarction and emergency bypass surgery consituted each 1.6 %. Death rate was 1.2 %. Stepwise regression analysis determined that modified AC/AHA classification of the primary target stenosis and the presence of diabetes mellitus were the only variables independently predictive of complications (target stenosis modified ACC/AHA score p=0.0002, diabetes mellitus p=0.0001). Complication rates for type A, B1, B2 and C were 3 %, 7.5 %, 13.8 % and 22 %, respectively. In conclusion, subdivision into types B1 and B2 provided significantly more information in this clinically important intermediate risk grup than did the standard ACC/AHA schema. The stenosis characteristics of bifurcation lesions and high-grade (80-99 %) stenosis were significantly correlated with procedural complications.