Five-year outcome in patients with isolated proximal left anterior descending coronary artery stenosis treated by angioplasty or left internal mammary artery grafting: a prospective trial.

Détails

ID Serval
serval:BIB_5F88B742E7AF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Five-year outcome in patients with isolated proximal left anterior descending coronary artery stenosis treated by angioplasty or left internal mammary artery grafting: a prospective trial.
Périodique
Circulation
Auteur(s)
Goy  J. J., Eeckhout  E., Moret  C., Burnand  B., Vogt  P., Stauffer  J. C., Hurni  M., Stumpe  F., Ruchat  P., von Segesser  L., Urban  P., Kappenberger  L.
ISSN
1524-4539 (Electronic)
ISSN-L
0009-7322
Statut éditorial
Publié
Date de publication
06/1999
Volume
99
Numéro
25
Pages
3255-9
Résumé
BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass surgery (CABG) improve the clinical status of patients with isolated proximal left anterior descending coronary artery stenosis. At 2 years, only additional revascularization was more frequently required after PTCA. METHODS AND RESULTS: We monitored 134 patients randomized to PTCA (n=68) or CABG (n=66) for </=5 years. End points were death, myocardial infarction, need for additional revascularization, clinical status, and medical treatment. At 5 years, 6 patients (9%) had died in the PTCA group versus 2 (3%) in the CABG group (P=0.12). One patient in each group died of a cardiac cause. Myocardial infarction was more frequent after PTCA (15% versus 4%; P=0.0001), but Q-wave infarction was not (6% in the PTCA group versus 3% in the CABG group; P=0.8). Additional revascularization was required in 38% of patients in the PTCA group versus 9% in the CABG group (P=0.0001). Functional status was comparable, with 6% of patients after PTCA and 3% after CABG in functional class III or IV. Finally, after PTCA or CABG, 62% and 91% of patients, respectively, were free of events (P=0.0001). CONCLUSIONS: The 5-year prognosis of patients with isolated proximal left anterior descending coronary artery stenosis is good. Both PTCA and CABG improve clinical status, but revascularization was needed more frequently after PTCA. There is an excess incidence of non-Q-wave myocardial infarction in the PTCA group that does not affect the vital or symptomatic outcome.
Mots-clé
*Angioplasty, Transluminal, Percutaneous Coronary *Coronary Artery Bypass/methods Coronary Disease/surgery/*therapy Female Follow-Up Studies Humans Male Mammary Arteries/surgery Middle Aged Prospective Studies Treatment Outcome
Pubmed
Web of science
Création de la notice
28/01/2008 10:52
Dernière modification de la notice
20/08/2019 15:17
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