Mortality after revascularization of the left anterior descending artery area

Abstract

Introduction: Surgical revascularization of the left anterior descending artery area using left internal mammary artery (LIMA) as a graft, and percutaneous coronary intervention have been proved as safe and effective treatment for coronary artery disease. Objective: The aim was to examine and compare the mortality and incidence of the major adverse cardiovascular and cerebrovascular events in patients with myocardial infarction and significant stenosis of the left anterior descending coronary artery (LAD) treated with coronary artery bypass grafting (CABG) using LIMA as a graft, and percutaneous coronary intervention (PCI) with stent implantation. Method: The study included 124 patients with myocardial infarction. 64 patients (57.6 ± 7.8 years old) were treated with CABG using left internal mammary artery to left anterior descending artery (LIMA-LAD), and 60 patients (56.5 ± 7.6 years) were treated with percutaneous coronary stent implantation in the LAD (p>0.05). Results: In the five-year period died 2 (3.3%) patients in the PCI treated group and 8 (12.5%) in CABG treated group (p<0.05). Ratio of registered major adverse cardiovascular and cerebrovascular events incidence in PCI and CABG group was as follows: myocardial infarction 0% to 9.4%, coronary reintervention 13.3% to 0%, CVI 3.3% to 3.1%. Total percentage of adverse cardiovascular and cerebrovascular events in the group PCI group was 16.7% (4.08% per year) and the in the group CABG group 12.5% (3.14% per year). There were no significant differences in the incidence of total cardiovascular and cerebrovascular events between the groups (p>0.05). Overall mortality and a major cardiovascular and cerebrovascular events in the PCI was 20.0% and in the CABG group 25.9%, which was not statistically significant (p>0.05). Conclusion: Mortality of patients treated with the left internal mammary artery to the left anterior descending artery bypass grafting was significantly higher than mortality of patients with stenosis of the LAD revascularized by percutaneous coronary intervention with stent implantation. There was no significant difference in the incidence of major adverse cardiovascular and cerebrovascular events in patients undergoing percutaneous coronary intervention and surgical revascularization in a five-year period.