In 1980, Emory Hospital became a pioneer of coronary angioplasty—the less-invasive alternative to coronary bypass surgery in which catheters are used to improve blood flow to the heart.

Twenty years and 34,508 coronary angioplasties later, the success rate of angioplasty at Emory has progressively increased, despite an older and sicker patient population with more complex coronary problems.

John Douglas, director of coronary intervention at the hospital and one of the most experienced interventional cardiologists in the world, presented data from Emory’s 20-year experience with angioplasty at the 73rd meeting of the American Heart Associa-tion in New Orleans,
Nov. 12–15.

“In our experience from 1980 through 1999, the success rate of angioplasty has progressively increased, while the risk of needing bypass surgery or of a heart attack complicating the procedure has decreased,” Douglas said. “We also have observed a decrease in the length of time patients must stay in the hospital which, along with reduced complications, has a major impact on cost.”

These successes have been realized despite an increasingly difficult patient population.

Over time, Douglas pointed out, the patient population needing angioplasties has become generally older, more patients have had prior heart attacks or have impaired heart function, and more patients have long-segment narrowing of the arteries. In addition, 26 percent of patients needing coronary angioplasty also have diabetes.

Since he began performing coronary angioplasty in 1980, Douglas, a professor of medicine in the School of Medicine, has earned international recognition for his expertise in the field he helped launch and has served on the American College of Cardiology committee that established recommendations for the development and maintenance of competency in coronary interventional procedures.

Douglas’ research has focused on improving the results of angioplasty by using stents, new antithrombotic agents and intracoronary radiation, and by developing methods to protect the myocardium (thickest part of the heart wall) from tiny blood clots.

The Andreas Gruentzig Cardiovascular Center at Emory Hospital was established in 1985 following the untimely death of Gruentzig, the first director of Emory’s interventional cardiology program.

Since its creation, the center has fostered numerous innovations, including the first coronary stent to be placed in a human in this country. The center also conducted the largest single-center study to compare angioplasty and coronary bypass surgery and performed the first studies of the use of beta radiation to prevent restenosis (renarrowing) after angioplasty.

“We always have ongoing clinical trials to investigate new strategies to improve patient outcomes,” Douglas said. “The goal is to make coronary intervention safer and more durable. This retrospective of our 20-year experience shows we are doing just that.”