Article Text

Download PDFPDF
A comparison of coronary artery stenting with angioplasty for isolated stenosis of the proximal left anterior descending coronary artery: five year clinical follow up
  1. F Versaci1,
  2. A Gaspardone1,
  3. F Tomai1,
  4. I Proietti1,
  5. A S Ghini1,
  6. L Altamura1,
  7. G Andò1,
  8. F Crea2,
  9. P A Gioffrè1,
  10. L Chiariello1
  1. 1Division of Cardiac Surgery, Università Tor Vergata, Rome, Italy
  2. 2Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy
  1. Correspondence to:
    Dr Francesco Versaci
    Divisione di Cardiochirurgia, Università di Roma Tor Vergata, European Hospital, Via Portuense 700, 00149 Rome, Italy;


Background: Stent implantation for isolated stenosis of the proximal left anterior descending coronary artery (LAD) with preserved left ventricular function has been found to have a better clinical and angiographic outcome at one year than balloon angioplasty (PTCA).

Objective: To establish whether those results are maintained at five year follow up.

Methods: Patients were followed at least every six months. For those who died during follow up, data were obtained from medical records.

Main outcome measures: Freedom from death, non-fatal myocardial infarction, cerebrovascular accident, and repeated target lesion revascularisation. Secondary end points were revascularisation in a remote region and freedom from angina.

Results: Follow up was complete in all patients. At five years, the primary end point was reached more often by patients randomised to stent implantation than to PTCA (80% v 53%; odds ratio (OR) 0.29 (95% confidence interval (CI) 0.13 to 0.69); p  =  0.0034). In the PTCA group, 35% of patients underwent target lesion revascularisation v 15% in the stent group (OR 0.33, 95% CI 0.13 to 0.80; p  =  0.014). There was a trend towards increased mortality in the PTCA group than in the stent group (17% v 7%; OR 0.36, 95% CI 0.10 to 1.21; p  =  0.098). No significant differences were found between PTCA and stent groups for non-fatal myocardial infarction (8% v 5%; OR 0.58, 95% CI 0.13 to 2.54; p  =  0.46) or cerebrovascular accident (2% v 0%).

Conclusions: In patients with isolated stenosis of the proximal LAD, a five year clinical follow up confirmed a better outcome in those treated with stenting than with PTCA.

  • left anterior descending coronary artery
  • coronary artery stenting
  • balloon dilatation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.