Angioplasty of the proximal left anterior descending coronary artery: initial success and long-term follow-up.

Abstract

From 1984 to 1987, 537 consecutive patients (mean age 58 years; range 34 to 79) underwent angioplasty for proximal left anterior descending coronary artery disease. The procedure was clinically successful in 516 (96.1%). Procedural complications included myocardial infarction (2.2%; Q wave 0.9%, non-Q wave 1.3%), in-hospital bypass surgery (3%) and death (0.4%). Follow-up was obtained in 534 patients (99.8%) for a mean duration of 44 months (range 8 to 75). Follow-up cardiac catheterization, performed in 391 patients (76%), demonstrated a 39.6% angiographic restenosis rate. Ninety-eight (19%) of the patients with a clinically successful result required additional revascularization for recurrent left anterior descending artery disease by angioplasty (12.8%) or coronary artery bypass grafting (4.7%), or both (1.5%). During follow-up there was a 2.5% incidence rate of myocardial infarction (anterior myocardial infarction 1.6%), and 27 patients (5.2%) died, 14 (2.7%) of cardiac causes. The actuarial 5-year cardiac survival rate was 97%, freedom from cardiac death and myocardial infarction was 94% and freedom from cardiac death, myocardial infarction, coronary artery bypass surgery and repeat left anterior descending artery angioplasty was 77%. At last follow-up 76% of patients were free of angina and 88% reported sustained functional improvement. Angioplasty is an effective treatment for proximal left anterior descending coronary artery disease that has a high success rate, low incidence of procedural complications and provides excellent long-term cardiac survival, freedom from cardiac events and sustained functional improvement.

• Authors: J H Frierson, A P Dimas, P L Whitlow, J L Hollman, D L Marsalese, C C Simpfendorfer, K Dorosti, I Franco
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 19 Issue 4 Pg. 745-51 (Mar 15 1992) ISSN: 0735-1097 [Print] United States
• PMID: 1545068 (Publication Type: Journal Article)

Topics

• Actuarial Analysis
• Angioplasty, Laser
• Coronary Artery Bypass
• Coronary Disease (mortality, therapy)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Multivariate Analysis
• Myocardial Infarction (epidemiology)
• Recurrence
• Risk Factors
• Survival Rate
• Time Factors