OBJECTIVES: The aim of this prospective, randomized trial was to assess the 10-year long-term safety and effectiveness of percutaneous coronary intervention (PCI) and minimally invasive direct coronary artery bypass surgery (MIDCAB) for the treatment of proximal left anterior descending (LAD) lesions. BACKGROUND: Long-term follow-up data comparing PCI and MIDCAB surgery for isolated proximal LAD lesions are sparse. METHODS:Patients with significant isolated proximal LAD stenoses were randomized either to PCI with bare-metal stents (n = 110) or MIDCAB (n = 110). At 10 years, data were obtained with respect to the primary endpoint (death, myocardial infarction, target vessel revascularization). Angina was assessed by the Canadian Cardiovascular Society classification. RESULTS: Follow-up was conducted for 212 patients at a median time of 10.3 years. There were no significant differences in the binary primary composite endpoint (47% vs. 36%; p = 0.12) and hard endpoints (death and infarction) between PCI and MIDCAB. However, a higher target vessel revascularization rate in the PCI group (34% vs. 11%; p < 0.01) was observed. Clinical symptoms improved significantly from baseline and were similar between both treatment groups. CONCLUSIONS: At 10-year follow-up, PCI and MIDCAB in isolated proximal LAD lesions yielded similar long-term outcomes regarding the primary composite clinical endpoint. Target vessel revascularization was more frequent in the PCI group.
RCT Entities:
OBJECTIVES: The aim of this prospective, randomized trial was to assess the 10-year long-term safety and effectiveness of percutaneous coronary intervention (PCI) and minimally invasive direct coronary artery bypass surgery (MIDCAB) for the treatment of proximal left anterior descending (LAD) lesions. BACKGROUND: Long-term follow-up data comparing PCI and MIDCAB surgery for isolated proximal LAD lesions are sparse. METHODS:Patients with significant isolated proximal LAD stenoses were randomized either to PCI with bare-metal stents (n = 110) or MIDCAB (n = 110). At 10 years, data were obtained with respect to the primary endpoint (death, myocardial infarction, target vessel revascularization). Angina was assessed by the Canadian Cardiovascular Society classification. RESULTS: Follow-up was conducted for 212 patients at a median time of 10.3 years. There were no significant differences in the binary primary composite endpoint (47% vs. 36%; p = 0.12) and hard endpoints (death and infarction) between PCI and MIDCAB. However, a higher target vessel revascularization rate in the PCI group (34% vs. 11%; p < 0.01) was observed. Clinical symptoms improved significantly from baseline and were similar between both treatment groups. CONCLUSIONS: At 10-year follow-up, PCI and MIDCAB in isolated proximal LAD lesions yielded similar long-term outcomes regarding the primary composite clinical endpoint. Target vessel revascularization was more frequent in the PCI group.
Authors: Monica Gianoli; Anne R de Jong; Kirolos A Jacob; Hanae F Namba; Niels P van der Kaaij; Pim van der Harst; Willem J L Suyker Journal: Int J Cardiol Heart Vasc Date: 2022-05-10
Authors: Mario Gaudino; Irbaz Hameed; Michael E Farkouh; Mohamed Rahouma; Ajita Naik; N Bryce Robinson; Yongle Ruan; Michelle Demetres; Giuseppe Biondi-Zoccai; Dominick J Angiolillo; Emilia Bagiella; Mary E Charlson; Umberto Benedetto; Marc Ruel; David P Taggart; Leonard N Girardi; Deepak L Bhatt; Stephen E Fremes Journal: JAMA Intern Med Date: 2020-12-01 Impact factor: 21.873
Authors: Francesco Costa; Sara Ariotti; Marco Valgimigli; Philippe Kolh; Stephan Windecker Journal: J Cardiovasc Transl Res Date: 2015-05-19 Impact factor: 4.132