Comparison of long-term efficacy of medical treatment versus percutaneous transluminal coronary angioplasty (PTCA) in single-vessel disease.

The long-term outcome of PTCA and medical therapy were compared in patients with SVD. All patients were confirmed to have > or - 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.