TITLE

Isolated high-grade lesion of the proximal LAD: a stent or off-pump LIMA?

AUTHOR(S)
Drenth, Derk J.; Veeger, Nic J.G.M.; Grandjean, Jan G.; Mariani, Massimo A.; van Boven, Ad J.; Boonstra, Piet W.
PUB. DATE
April 2004
SOURCE
European Journal of Cardio-Thoracic Surgery;Apr2004, Vol. 25 Issue 4, p567
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: The objective of this study was to compare the long-term outcome of patients with an isolated high-grade stenosis of the left anterior descending (LAD) coronary artery randomized to percutaneous transluminal coronary angioplasty with stenting (PCI, stenting) or to off-pump coronary artery bypass grafting (surgery). Methods: Patients with an isolated high-grade stenosis (American College of Cardiology/American Heart Association classification type B2/C) of the proximal LAD were randomly assigned to stenting (n=51) or to surgery (n=51) and were followed for 3–5 years (mean 4 years). Primary composite endpoint was freedom from major adverse cardiac and cerebrovascular events (MACCEs), including cardiac death, myocardial infarction, stroke and repeat target vessel revascularization. Secondary endpoints were angina pectoris status and need for anti-anginal medication at follow-up. Analysis was by intention to treat. Results: MACCEs occurred in 27.5% after stenting and 9.8% after surgery (P=0.02; absolute risk reduction 17.7%). Freedom from angina pectoris was 67% after stenting and 85% after surgery (P=0.036). Need for anti-anginal medication was significantly lower after surgery compared to stenting (P=0.002). Conclusion: Patients with an isolated high-grade lesion of the proximal LAD have a significantly better 4-year clinical outcome after off-pump coronary bypass grafting than after PCI.
ACCESSION #
12576218

 

Related Articles

  • A Randomized Trial Comparing Coronary Angioplasty with Coronary Bypass Surgery. King, Spencer B.; Lembo, Nicholas J.; Weintraub, William S.; Kosinski, Andrzej S.; Barnhart, Huiman X.; Kutner, Michael H.; Alazraki, Naomi P.; Guyton, Robert A.; Zhao, Xue-Qiao // New England Journal of Medicine;10/20/94, Vol. 331 Issue 16, p1044 

    Background: The clinical benefit of percutaneous transluminal coronary angioplasty (PTCA) as compared with coronary-artery bypass grafting (CABG) for patients with multivessel coronary artery disease has not been established. To determine the outcomes of these treatments in patients referred for...

  • Coronary Angioplasty Compared with Bypass Grafting. Hillis, L. David; Rutherford, John D. // New England Journal of Medicine;10/20/94, Vol. 331 Issue 16, p1086 

    Editorial. Discusses an article by Hamm, et al, in the October 20, 1994 issue of the `New England Journal of Medicine' dealing with a prospective, randomized study of angioplasty and bypass grafting in patients with multivessel coronary artery disease.

  • Bypassing the balloon?  // People's Medical Society Newsletter;Dec96, Vol. 15 Issue 6, p1 

    Details the findings of a study by the National Heart, Lung and Blood Institute which compares coronary-artery bypass graft (CABG) with balloon angioplasty. Effectiveness; Survival rate of patients; Angioplasty as an alternative to CABG for treating patients with blockages of multiple coronary...

  • Management of multivessel coronary artery disease.  // American Family Physician;3/1/1996, Vol. 53 Issue 4, p1393 

    Reports on a study published in the 1995 issue of the `American Journal of Cardiology' periodical by Sim and associates who performed a meta-analysis of reported randomized trials to compare results of coronary artery bypass surgery with those of percutaneous transluminal angioplasty in patients...

  • Once again, CABG vs PTCA--trial results today. Goldsmith, Marsha F. // JAMA: Journal of the American Medical Association;1/26/94, Vol. 271 Issue 4, p257 

    Reports on the findings of the American Heart Association (AHA) on the similarities between coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) as treatments for occlusive heart disease. Similarity of costs and charges; Angioplasty as viable...

  • Bypass and angioplasty outcomes differ at first, but even out at 5 years.  // Modern Medicine;May97, Vol. 65 Issue 5, p15 

    Reports on a study by George Sopko and colleagues, which shows the similarity of five-year outcomes of percutaneous transluminal coronary angioplasty and coronary artery bypass grafting. Angina/exercise-induced ischemia; Recovery time; Revascularization; Administration of anti-ischemic drugs.

  • Revascularization in the 21st century. Pinkowish, Mary Desmond // Patient Care for the Nurse Practitioner;Jan2001, Vol. 4 Issue 1, p36 

    Presents information on advances and developments in coronary revascularization. Issues surrounding the use of coronary artery bypass graft and percutaneous transluminal angioplasty; Developments in stent-based therapies; Advances in surgical treatments.

  • Bypass grafts protect diabetic patients better than angioplasty. Gottlieb, Scott // BMJ: British Medical Journal (International Edition);04/15/2000, Vol. 320 Issue 7241, p1029 

    Provides information on a second report which stated that people with diabetes who have coronary artery disease fare better after bypass surgery than after balloon angioplasty. Survival rates of diabetic patients who had undergone angioplasty and bypass surgery; Details on the report.

  • CABG or angioplasty in patients with diabetes? Pinkowish, Mary Desmond // Patient Care;2/15/1998, Vol. 32 Issue 3, p157 

    Presents a study which compares the use of coronary artery bypass graft (CABG) surgery to percutaneous transluminal coronary angioplasty (PTCA) for revascularization in diabetic patients. Reference to a 1995 clinical alert from the National Heart, Lung, and Blood Institute; Views from...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics