Percutaneous Transluminal Coronary Angioplasty In Patients Research Articles

ROLE OF SHORT SIX WEEKS HOME BASED AEROBIC EXERCISES IN PATIENTS WITH POST PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA)

To examine the cardiovascular adaptations and functional capacity (6 min walk test, rate of perceived exertion, resting heart rate, maximal heart rate, systolic and diastolic blood pressure, mean arterial blood pressure) by giving Aerobic Exercises in Post Percutaneous Transluminal Coronary Angioplasty patients. The need for the study is to know the efficiency of aerobic exercises in post percutaneous transluminal coronary angioplasty (PTCA). To evaluate whether the patient can perform the aerobic exercises with -out any difficulty. To evaluate the effects of aerobic exercises on an individual with post PTCA and lead a better life after post PTCA. Key Words: Percutaneous Transluminal Coronary Angioplasty (PTCA); Resting Heart Rate (RHR); Maximal Heart Rate (MHR); Blood Pressure (BP); Systolic Blood Pressure (SBP); Diastolic Blood Pressure (DBP); Mean Arterial Blood Pressure (MRBP) cardiovascular diseases (CVD); Coronary heart diseases (CHD).

Search for familial hypercholesterolemia patients in an Italian community: A real-life retrospective study

Background and aimsFamilial hypercholesterolemia (FH) is a common inherited disorder of low-density lipoprotein (LDL) catabolism that causes elevated LDL-cholesterol (LDL-C) and premature atherosclerotic cardiovascular disease (ASCVD). Despite the availability of effective treatments, FH remains underdiagnosed and undertreated. The aims of the study were to identify putative FH subjects using data from laboratory and cardiology databases, genetically characterize suspected FH patients referred to the Lipid Clinic and monitor attainment of treatment goals in identified patients. Methods and resultsWe retrieved the electronic health records of 221,644 individuals referred to laboratory for routine assessment and of 583 ASCVD patients (age ≤65) who underwent percutaneous transluminal coronary angioplasty (PTCA). We monitored the lipid profiles of subjects with LDL-C ≥ 250 mg/dl identified by laboratory survey (LS-P), PTCA patients and patients from the Lipid Clinic (LC-P). The laboratory survey identified 1.46% of subjects with LDL-C ≥ 190 mg/dl and 0.08% with LDL-C ≥ 250 mg/dl. Probable/definite FH was suspected in 3% of PTCA patients. Molecularly-confirmed FH was found in 44% of LC-P subjects. Five new LDLR mutations were identified. The 50% LDL-C reduction target was achieved by 70.6% of LC-P patients. Only 18.5% of PTCA patients reached the LDL-C < 55 mg/dl target. ConclusionBy using a combined approach based on laboratory lipid profiles, documented ASCVD and Lipid Clinic data, we were able to identify subjects with a high probability of being FH. Attainment of LDL-C goals was largely suboptimal. Efforts are needed to improve FH detection and achievement of lipid targets.

Depression anticipates patients at risk of poor exercise stress test performance after percutaneous coronary angioplasty: A short-term longitudinal study

AimsThe exercise stress test is commonly used to assess physical capacity and recovery in coronary artery disease (CAD) patients after percutaneous transluminal coronary angioplasty (PTCA). Despite depressive symptoms have been consistently associated with adverse outcomes in CAD patients, they are rarely considered as risk factors of poor exercise test. The present study investigated the influence of depressive symptoms, along with anxiety, sleep problems and perceived health on exercise test in PTCA patients. MethodsOne hundred and sixty-five patients who underwent PTCA completed the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory, the Sleep Condition Index and the 12-item Short-Form Health Survey and, after 20 days, underwent exercise stress test. ResultsHigher BDI-II scores significantly predicted lower maximal workload measured in metabolic equivalents (METs; β = −0.13; p = .030), shorter total exercise duration (β = −5.23; p = .034) and the inability to reach maximum heart rate during exercise test (OR = 1.07; p = .032), even after controlling for relevant sociodemographic and biomedical risk factors. ConclusionsDepressive symptoms specifically predicted worse exercise stress test performance in patients after PTCA, controlling for common risk factors. Focusing on the assessment of depressive symptoms, in addition to sociodemographic and biomedical risk factors, is essential to anticipate patients at risk of poor physical capacity after PTCA.

ASSOCIATION BETWEEN THE WEIGHT LOSS AND ANXIETY, DEPRESSION AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY: A NEED FOR PRE-DISCHARGED COUNSELING

Objectives: To see the association between weight loss and anxiety, depression after percutaneous transluminal coronary angioplasty (PTCA) for coronary artery disease patients. (1) To see the severity of anxiety and depression 1 month after PTCA, (2) to evaluate the relationship between the weight changes and major adverse cardiac events (MACE) in 1 month follow-up.Methods: A total 1001 patients who underwent PTCA for acute coronary syndrome and coronary heart disease were included. Data were collected at baseline and 1 month after PTCA. A validated Euro 5Q-5D-5L questionnaire was used to assess the level of anxiety and depression. Chi-square test was applied to find out the association between weight loss status and anxiety, depression.Results: There was a significant decrease in mean weight 1 month after coronary angioplasty (64.18±11.022 vs. 61.96±11.17, p&lt;0.001). No association was observed between weight loss status and anxiety, depression in PTCA patients (p=0.5) and there is no significant association between weight changes and MACE 1 month after PTCA (p=0.92).Conclusion: Data show that anxiety and depression were observed in 64.9% of the study population after coronary angioplasty but anxiety and depression are not associated with weight loss after PTCA. Loss of weight may be due to the modified post angioplasty lifestyles such as adherent to Mediterranean diet, physical exercise, cessation of smoking, optimum control of blood pressure, blood sugar, and blood cholesterol along with prescribed medications. Anxiety and depression may turn into chronic stage if not treated wisely could lead to significant MACE. Proper pre-hospital discharge counseling is necessary for all post PTCA patients to sustain their quality of life.

Healthy Lifestyle Behaviours of Percutaneous Transluminal Coronary Angioplasty Patients and the Affecting Factors

Healthy Lifestyle Behaviours of Percutaneous Transluminal Coronary Angioplasty Patients and the Affecting Factors

Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty.

ObjectiveTo explore how older patients self-manage their coronary heart disease (CHD) after undergoing elective percutaneous transluminal coronary angioplasty (PTCA).MethodsThis mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients (n = 93) approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings informed the purposive sampling for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualitative data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants (n = 47) classified as 65 years of age or older.Results78.7% (n = 37) of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% (n = 16) thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% (n = 19) would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less (P = 0.02) and smoked less (P = 0.01) than their younger counterparts in the study. Age did not seem to affect PTCA patients' likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption (P = 0.237).ConclusionsThe findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants' likelihood to alter lifestyle factors.

의료보장유형에 따른 Percutaneous Transluminal Coronary Angioplasty 입원 환자의 의료이용 차이 분석: Propensity Score Matching을 이용하여

Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn’t show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

Long-term Outcomes of Dialysis Patients After Coronary Revascularization: A Population-based Cohort Study in Taiwan

The outcomes of Chinese patients undergoing dialysis after coronary revascularization are unknown. We examined the outcomes of Taiwanese dialysis patients after coronary artery bypass grafting (CABG), percutaneous transluminal coronary angioplasty (PTCA), or coronary stenting. Using data from the National Health Research Institute database, we determined the outcomes of 1,287 dialysis patients who underwent initial coronary revascularization between 1997 and2008. The 7-year overall survival rates were 69 ± 4%, 68 ± 3%, and 57 ± 2% for the CABG, stent, and PTCA patients (p= 0.001), respectively. After demographic and comorbidity adjustment, hazard ratios (HRs) for all-cause death in the CABG (vs. PTCA) and stent (vs. PTCA) patients were 0.695 (p= 0.015) and 0.721 (p= 0.009). Additionally, no significant difference in all-cause death was found between the CABG and stent patients. Moreover, the ≥65-year-old CABG group patients and the <65-year-old coronary stent group patients showed better survival than the PTCA group patients. Compared with the PTCA and CABG groups, the coronary stent group was significantly associated with a higher risk for recurrent acute myocardial infarction (AMI). Based on age stratification, the ≥65-year-old stent group had a higher risk for recurrent AMI than the PTCA group (HR, 1.562; p= 0.026). Chinese patients undergoing dialysis who underwent CABG or coronary stenting had better survival than those who underwent PTCA. Moreover, being ≥65 years old, CABG shows better survival compared with PTCA; being <65 years old, coronary stenting show better survival compared with PTCA.

Relation of Depression, Anxiety, and Quality of Life with Outcome after Percutaneous Transluminal Coronary Angioplasty

Background. Despite, increasing number of percutaneous transluminal coronary angioplasty (PTCA) being performed, there is a paucity of Indian studies on the psychological effects of PTCA. Aim. To study the relation of anxiety, depression, and health related quality of life with outcome after PTCA. Methods. A total of 35 patients undergoing PTCA were included in the present project with their informed consent. All patients filled a specially designed proforma, the Hospital Anxiety and Depression Scale, Coronary Scale, Seattle Angina Questionnaire, and a health related quality of life measure (EQ 5D) one day before undergoing PTCA. Three days after PTCA patients were reassessed with the Hospital anxiety & depression scale, Seattle angina questionnaire and the EQ 5D. Results. Analysis showed that 46% had significant anxiety and 32.1% had significant depression before PTCA. Following successful PTCA, none of the patients had significant anxiety, and only 2 (3.6%) had significant depression. On the Seattle Angina Questionnaire, physical limitation reduced from 67.9 to 48. Disease perception improved from 21.2 to 37.1. On the EQ5D, the health status improved from 42.7 before PTCA to 78.7 after PTCA. Conclusion. Successful PTCA resulted in significant reduction in anxiety, depression, and physical limitation and improvement in disease perception and health status.

Oxidative and Antioxidative Status after Successful Percutaneous Transluminal Coronary Angioplasty in Acute Myocardial Infarction

Background: Oxidants lead to cell death through apoptosis and necrosis. The effects of reactive oxygen radicals are balanced by the antioxidant action. The aim of this study was to assess and compare the oxidative and antioxidative status, both in healthy control subjects and in patients with acute myocardial infarction after successful Percutaneous Transluminal Coronary Angioplasty (PTCA). Materials and methods: 25 patients who were re-vascularised in the first six hours of Acute ST elevated myocardial infarction and 25 healthy controls were included in the study. Erythrocyte Total Superoxide Scavenger Activity (TSSA), Non-enzymatic Superoxide Scavenger Activity (NSSA), superoxide dismutase (SOD), Nitric Oxide (NO), glutathione peroxidase (GPX) activities and glutathione (GSH), malondialdehyde (MDA) and 8 hydroxydeoxyguanosine (8-OHdG) levels were measured before PTCA (zero-time) after the 6th hour and 24th hour from PTCA in patients and once in the controls. Results: There was a decrease at MDA concentrations (3.99±1.14, 4.05±1.35, 3.62±1.11nmol/g Hb, p<0.05), however, 8-OHdG concentrations significantly increased in patient at zero-time and 6 th

Percutaneous transluminal coronary angioplasty in Nepalese diabetic patients: Do they carry extra risk to revascularization process?

Background and Objectives: There is evidence that diabetes carries risk of various complications and adverse outcome with coronary revascularisation procedures. The aim of this study was to analyze the outcomes and complications of Percutaneous Transluminal Coronary Angioplasty in Nepalese diabetic patients compared to non-diabetic patients. Method: A hospital-based comparative cross-sectional study was conducted at Norvic International Hospital, Kathmandu, Nepal. A total of 702 consecutive Percutaneous Transluminal Coronary Angioplasty patients coming to the hospital from 2002 to 2010 were included. Angioplasty was performed using radial and femoral routes in a standard setting with standard techniques. Information on other background risk factors was recorded. Success of the procedures and presence of major and minor complications were observed. Results: Of the 702 patients participating in this study, 259 were diabetic and 443 were non-diabetic. Success rates were similar: 256 (98.8%) of diabetic and 438 (98.8%) of non-diabetic had a successful Percutaneous Transluminal Coronary Angioplasty. Complications of the procedure were however higher in the diabetic patients with higher in-hospital death (odds ratio 3.4, 95% confidence Interval: 0.6-19.1), compared to non-diabetic patients. Conclusion: The overall outcome of Percutaneous Transluminal Coronary Angioplasty was equally successful in diabetic and non-diabetic populations groups. But the complications were higher with the diabetic group which were because of presence of other co-morbidities in this group and were not procedure-related. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7250 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.16-20

Four-Dimensional Speckle Tracking for Assessing Improvement in Left Ventricular Contractility After Coronary Angioplasty

The objective of the study was to identify and quantify the potential improvement of left ventricular contractility after percutaneous transluminal coronary angioplasty (PTCA) using 4-dimensional (4D) speckle tracking echocardiography (4D STE). We investigated 41 patients with coronary disease by 4D STE pre- and 24 hours postcoronarography with (n = 18) or without (n = 23) PTCA. The 4D STE visualizes in real time the myocardium strain on 2- and 4-chamber apical views and on 3 transverse views of the left ventricle. Average and total strain of the left ventricle were measured. Of the 18 PTCA patients, 15 showed significant increase in left ventricle mean (+15 ± 6) and total strain (240 ± 100), which corresponded to an increase of 93% ± 55% from precoronarography, whereas the remainder showed no change. The total strain corresponded to 33% ± 10% (before PTCA) and 59% ± 11% (post PTCA) of the estimated normal strain for each patient. Strain improved in 70% of the segment downstream from the stent, and there was a negative correlation between the amplitude of the mean and total strain improvements after 24 hours and the mean and total strain values before PTCA. In the non-PTCA group, 21 of the 23 patients showed no changes in strain, whereas 2 showed improvement. The 4D STE showed significant improvements in left ventricular contractility in more than 70% of the areas downstream from the PTCA segment. This corresponded to an increase in the initial contractility by approximately 93% ± 55%; however, the myocardium contractility remained approximately 59% of normal level. No changes were seen in patients without PTCA.

Fourth review of the UK national patient dose database

Fourth review of the UK national patient dose database

Kodak EDR2 film for patient skin dose assessment in cardiac catheterization procedures

Patient skin doses were measured using Kodak EDR2 film for 20 coronary angiography (CA) and 32 percutaneous transluminal coronary angioplasty (PTCA) procedures. For CA, all skin doses were well below 1 Gy. However, 23% of PTCA patients received skin doses of 1 Gy or more. Dose-area product (DAP) was also recorded and was found to be an inadequate indicator of maximum skin dose. Practical compliance with ICRP recommendations requires a robust method for skin dosimetry that is more accurate than DAP and is applicable over a wider dose range than EDR2 film.

Sense of Coherence and Health-Related Quality of Life among Patients Undergoing Coronary Artery Bypass Grafting or Angioplasty

Every year, 4 million people die from cardiovascular disease (CAD) in Europe. As many as 800,000 of them die before they reach the age of 65. The ischemic heart disease is also the most common cause of death in Finland. The invasive treatments of the CAD, coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) relieve symptoms and increase patient's health-related quality of life (HRQoL) in most of the cases. In this paper sense of coherence is discussed as related to health-related quality of life among CABG and PTCA patients in a one-year follow-up. The study sample consisted of consecutive male (N=439) and female (N=176) patients who were treated with the elective CABG or PTCA. The baseline data before the interventions were collected by structured interviews, the follow-up data by mailed self-administered questionnaires six and twelve months afterwards. The sense of coherence was studied by using a 13-item SOC scale. HRQoL was measured by the 15D. It is a generic, multidimensional, standardized, self-administered instrument, which has both a profile and single index score property. The differences in both groups were defined by using T-tests. Follow-up outcomes were analysed by using analyses of variance for repeated measures. Health-related quality of life increased in both groups during the follow-up. There was a correlation between health-related quality of life and sense of coherence in CABG and PTCA patients' group at baseline. The mean score of the 15D was lower in moderate sense of coherence tertile than in strong sense of coherence tertile in both groups. After six and twelve months the similar tendency existed in health-related quality of life and sense of coherence; patients who had poor or moderate sense of coherence had lower health-related quality of life than the patients with strong sense of coherence. Sense of coherence was more stable among CABG patients than PTCA patients. In PTCA patients' group sense of coherence decreased during the follow-up time. In both patients' group the health-related quality of life increased statistically significant by 6 months. No significant change in health-related quality of life took place in either group from 6 to 12 months.

Treatments of Coronary Artery Disease Improve Quality of Life in the Long Term

Cardiovascular diseases are currently the most common cause of death worldwide. This trend has been predicted to continue until 2020. The effects of treatments by bypass operation or angioplasty on the long-term health-related quality of life (HRQoL) in patients with coronary artery disease (CAD) have not been adequately studied. To measure the HRQoL and its changes during 8 years of follow-up after a treatment intervention. The primary study series consisted of 280 patients, of whom 100 underwent coronary artery bypass grafting (CABG), 100 had percutaneous transluminal coronary angioplasty (PTCA), and 80 were prescribed medication. At 1 year, 81 CABG patients, 74 PTCA patients, and 64 patients in the medication group responded. In the final analysis after 8 years, 63 CABG patients, 57 PTCA patients, and 34 patients in the medication group remained. HRQoL surveys were conducted 1 and 8 years after the treatment interventions. HRQoL was measured using the Nottingham Health Profile (NHP), which has been tested and evaluated in Finland. CABG patients had a statistically significantly better HRQoL 8 years after the operation than at baseline on the dimensions of mobility (p <.001), energy (p =.003), and pain (p =.031). PTCA patients had a statistically significantly better HRQoL 8 years after the intervention on the dimensions of emotional reactions (p =.002), pain (p =.003), mobility (p =.004), and energy (p =.005). A significant impairment on the dimension of sleep had taken place during the 8 years follow-up after PTCA (p =.018). No significant changes were seen in the HRQoL of the patients on medication at either 1 or 8 years. The need for treatment and primary and secondary prevention of CAD will increase in the future, especially in the case of high-risk patients. The present findings indicate that CABG and PTCA continue to significantly improve CAD patients' HRQoL 8 years after the intervention.

Effects of a comprehensive cardiac rehabilitation on body composition in coronary artery bypass graft versus percutaneous transluminal coronary angioplasty patients

Effects of a comprehensive cardiac rehabilitation on body composition in coronary artery bypass graft versus percutaneous transluminal coronary angioplasty patients

Health-related quality of life of coronary artery bypass grafting and percutaneous transluminal coronary artery angioplasty patients: 1-year follow-up

The aim of the study was to compare the health-related quality of life (HRQoL) of patients undergoing coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) before the interventions and 6 and 12 months afterward, and to compare their HRQoL also with that of the general population. The sample (n = 615) consisted of consecutive coronary artery disease patients treated with elective CABG (n=432) or PTCA (n=183). The baseline data before the treatments were collected by structured interview, the follow-up data mainly by mailed self-administered questionnaires. HRQoL was measured by the 15D. For comparisons, the groups were standardized for differences in socioeconomic and clinical characteristics with a regression analysis. At baseline, the average 15D scores of the patient groups were 0.752 (95 percent confidence interval [CI], 0.743-0.761) in CABG and 0.730 (95 percent CI, 0.716-0.744) in PTCA. After standardization, the difference between the groups was statistically significant but not clinically important. These scores were significantly worse (statistically and clinically) than the score of 0.883 (95 percent CI, 0.871-0.879) in the general population sample matched with the gender and age distribution of the patients. By 6 months, the CABG and PTCA patients had experienced a statistically significant and clinically important improvement to 0.858 (95 percent CI, 0.844-0.872) and 0.824 (95 percent CI, 0.806-0.842), respectively. No significant change took place in either group from 6 to 12 months. Both CABG and PTCA produces an approximately similar, clinically important improvement in HRQoL in 1-year follow-up.

Changes in myocardial perfusion due to physical exercise in patients with stable coronary artery disease

Percutaneous transluminal coronary angioplasty (PTCA) is one of the main therapy options for patients with coronary artery disease (CAD), resulting in an improvement in myocardial perfusion and exercise capacity. Nevertheless, studies have also demonstrated a positive effect of regular exercise training on myocardial perfusion and maximum exercise capacity. The aim of this study was to evaluate changes in myocardial stress perfusion after 1 year of exercise training in comparison with the effects of PTCA in patients with CAD. In 66 male patients with angiographically confirmed significant coronary artery stenosis in one target vessel, myocardial perfusion scintigraphy was performed at baseline and 12 months after randomisation into either a physical exercise group or a PTCA group. Circumferential count rate profiles in 16 wall segments were classified according to their relative count rate and localisation within or outside the area supplied by the stenosed vessel. Ischaemic segments showed a significant improvement in myocardial count rate within the target area after 12 months in both the PTCA and the training group (PTCA group: from 76.8+/-4.9% to 86.6+/-10.9%, p=0.03; training group: from 74.0+/-7.3% to 83.7+/-10.8%, p<0.01). Outside the target area only the training group showed a significant improvement (from 77.7+/-4.4% to 91.7+/-4.8%, p<0.01). Our data indicate a significant improvement in stress myocardial perfusion in the training group after 12 months. The ischaemia is reduced not only in the target region of the leading stenosis but also in other ischaemic myocardial areas. In contrast, after PTCA stress perfusion improves only in the initially ischaemic parts of the target area.

Coronary Angioplasty and Cancer Risk: A Population-Based Cohort Study in Sweden

Percutaneous transluminal coronary angioplasty (PTCA) has become the reperfusion method of choice in patients with coronary artery disease. This sometimes complicated and lengthy procedure is performed using fluoroscopy and cineradiography or digital imaging, which may result in considerable exposure to ionizing radiation. Possible cancer risks in PTCA patients have been discussed, but never before examined in a population-based setting. To assess the cancer risks following PTCA. A cohort study was carried out based on nationwide registration of all coronary angioplasty procedures in Sweden between 1989 and 1998. The study encompassed a total of 23,097 PTCA patients followed up for cancer outcomes in the Swedish Cancer Register until December 31, 2000. The mean and median follow-up times were 4.8 and 4.5 years, respectively. The main outcome measures were standardized incidence ratios of cancer. Except for a transient excess of lung cancers, observed number of cancers in patients who had undergone coronary angioplasty did not differ from those expected in the general population. If anything, the overall cancer risk was lower in the PTCA group (SIR 0.94; 95% CI 0.88-0.99). In particular, no increased risks were detected for leukemias or thyroid cancer. There was no indication of increased risks of leukemia or cancers overall in PTCA patients.