Stephan Blazek1, Cornelius Rossbach1, Michael A Borger2, Georg Fuernau1, Steffen Desch3, Ingo Eitel3, Thomas Stiermaier1, Philipp Lurz1, David Holzhey2, Gerhard Schuler1, Friedrich-Wilhelm Mohr2, Holger Thiele4. 1. Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. 2. Department of Cardiac Surgery, University of Leipzig-Heart Center, Leipzig, Germany. 3. Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany; Medical Clinic II, University of Lübeck, Lübeck, Germany. 4. Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany; Medical Clinic II, University of Lübeck, Lübeck, Germany. Electronic address: holger.thiele@uksh.de.
Abstract
OBJECTIVES: The aim of this analysis was to assess the 7-year long-term safety and effectiveness of a randomized comparison of percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES) versus minimally invasive direct coronary artery bypass (MIDCAB) surgery for the treatment of isolated proximal left anterior descending lesions. BACKGROUND: Long-term follow-up data comparing PCI by SES and MIDCAB surgery for isolated proximal left anterior descending lesions are sparse. METHODS: Patients were randomized either to PCI with SES (n = 65) or MIDCAB (n = 65). Follow-up data were obtained after 7 years with respect to the primary composite endpoint of death, myocardial infarction, and target vessel revascularization. Angina was assessed by the Canadian Cardiovascular Society classification and quality of life with Short Form 36 and MacNew quality of life questionnaires. RESULTS: Follow-up was conducted in 129 patients at a median time of 7.3 years (interquartile range: 5.7, 8.3). There were no significant differences in the incidence of the primary composite endpoint between groups (22% PCI vs. 12% MIDCAB; p = 0.17) or the endpoints death (14% vs. 17%; p = 0.81) and myocardial infarction (6% vs. 9%, p = 0.74). However, the target vessel revascularization rate was higher in the PCI group (20% vs. 1.5%; p < 0.001). Clinical symptoms and quality of life improved significantly from baseline with both interventions and were similar in magnitude between groups. CONCLUSIONS: At 7-year follow-up, PCI by SES and MIDCAB in isolated proximal left anterior descending lesions yielded similar long-term outcomes regarding the primary composite clinical endpoint and quality of life. Target vessel revascularization was more frequent in the PCI group. (MIDCAB Versus DES in Proximal LAD Lesions; NCT00299429).
RCT Entities:
OBJECTIVES: The aim of this analysis was to assess the 7-year long-term safety and effectiveness of a randomized comparison of percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES) versus minimally invasive direct coronary artery bypass (MIDCAB) surgery for the treatment of isolated proximal left anterior descending lesions. BACKGROUND: Long-term follow-up data comparing PCI by SES and MIDCAB surgery for isolated proximal left anterior descending lesions are sparse. METHODS:Patients were randomized either to PCI with SES (n = 65) or MIDCAB (n = 65). Follow-up data were obtained after 7 years with respect to the primary composite endpoint of death, myocardial infarction, and target vessel revascularization. Angina was assessed by the Canadian Cardiovascular Society classification and quality of life with Short Form 36 and MacNew quality of life questionnaires. RESULTS: Follow-up was conducted in 129 patients at a median time of 7.3 years (interquartile range: 5.7, 8.3). There were no significant differences in the incidence of the primary composite endpoint between groups (22% PCI vs. 12% MIDCAB; p = 0.17) or the endpoints death (14% vs. 17%; p = 0.81) and myocardial infarction (6% vs. 9%, p = 0.74). However, the target vessel revascularization rate was higher in the PCI group (20% vs. 1.5%; p < 0.001). Clinical symptoms and quality of life improved significantly from baseline with both interventions and were similar in magnitude between groups. CONCLUSIONS: At 7-year follow-up, PCI by SES and MIDCAB in isolated proximal left anterior descending lesions yielded similar long-term outcomes regarding the primary composite clinical endpoint and quality of life. Target vessel revascularization was more frequent in the PCI group. (MIDCAB Versus DES in Proximal LAD Lesions; NCT00299429).
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: Rafik Abusamra; Marek Król; Krzysztof Milewski; Mateusz Kachel; Loai Abudaqa; Justyna Jankowska-Sanetra; Kamil Derbisz; Krzysztof Sanetra; Anna Sobieszek; Piotr P Buszman; Wojciech Wojakowski; Paweł E Buszman; Andrzej Bochenek; Marek Cisowski Journal: Cardiol J Date: 2019-01-31 Impact factor: 2.737