Comparison of Long-term Efficacy of Medical Treatment versus Percutaneous Transluminal Coronary Angioplasty (PTCA) in Single-vessel Disease

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The long-term outcome of PTCA and medical therapy were compared in patients with SVD. All patients were confirmed to have ≥75% stenosis of a major coronary artery by coronary arteriogram. The 5-year survival rates were 96.0% for medical therapy and 98.9% for successful angioplasty. Both therapies achieved an equally good long-term outcome for SVD. The incidence of nonfatal cardiac events during follow up was higher in patients treated by PTCA than in those on medical therapy, but there was no difference between the two groups in the incidence of nonfatal MI at 5 years (2.5% vs 1.8%). The most common cardiac event in patients undergoing successful PTCA was repeat intervention associated with restenosis.
In view of the long-term efficacy of PTCA, the high restenosis rate remains an important problem and it is necessary to elucidate the causes of restenosis and develop countermeasures as soon as possible. (Jpn Heart J 36: 565-572, 1995)