Coronary angioplasty for patients with multivessel coronary artery disease: follow-up clinical status.

To determine the value of percutaneous transluminal coronary angioplasty (PTCA) for patients with multivessel coronary artery disease, we reviewed follow-up data of 92 consecutive multivessel disease patients in whom PCTA had been successful and in whom at least 6 months had elapsed. Clinical outcome of multivessel disease patients was compared to that of 189 patients with single-vessel disease who experienced successful PTCA. Eighty percent of multivessel disease patients noted clinical improvement at follow-up. More single-vessel disease patients, however, were free of angina (77% vs 63%, p = 0.02), were not taking long-acting antianginal medicationS (46% vs 27%, p less than 0.001), and had repeat PTCA less often (5% vs 12%, p = 0.05) than multivessel disease patients. The incidence of late clinical events such as myocardial infarction, coronary artery bypass surgery, and death was low in both single- and multivessel disease patients. To determine whether the degree of revascularization achieved accounted for differences between single- and multivessel disease outcome, PTCA for multivessel disease was classified as either complete or incomplete revascularization. Those patients classified as having incomplete revascularization, although they had multivessel coronary artery disease, had only one significant ischemic zone and this was successfully revascularized by PTCA. There was no significant difference in anginal status or incidence of myocardial infarction, coronary artery bypass surgery, or death between the two multivessel disease subgroups. Thus, PTCA is of clinical value for selected patients with multivessel coronary artery disease, even in those who are incompletely revascularized by design.