A Comparison of Coronary-Artery Stenting with Angioplasty for Isolated Stenosis of the Proximal Left Anterior Descending Coronary Artery
Key result
Coronary stenting for proximal LAD stenosis improved 12-month event-free survival (87% vs 70%, P=0.04) and reduced restenosis (19% vs 40%, P=0.02) compared to standard angioplasty.
Why the study?
Does coronary-artery stenting improve procedural success and event-free survival compared to standard coronary angioplasty in patients with isolated stenosis of the proximal left anterior descending coronary artery?
Population
120 patients with symptomatic isolated stenosis of the proximal left anterior descending coronary artery
Comparison
Coronary-artery stent implantation vs Standard coronary angioplasty
Design
RCT, randomly assigned
Follow-up
12 months
Authors
Discussion
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Implication
Stenting should be preferred over angioplasty for proximal LAD stenosis; extends RCT evidence to this high-risk subset.
Key Points
- This study aims to compare the effectiveness of coronary-artery stenting versus angioplasty for treating isolated stenosis of the proximal left anterior descending coronary artery.
- 120 patients were randomly assigned to receive either stent implantation or standard angioplasty.
- Primary endpoints included procedural success, event-free survival at 12 months, and rate of restenosis at 12 months.
- Procedural success rates were similar (95% for stenting vs. 93% for angioplasty, P=0.98).
- 12-month event-free survival rates were significantly higher in the stenting group (87% vs. 70%, P=0.04).
- Restenosis rates were notably lower after stenting (19% vs. 40% after angioplasty, P=0.02).
Structured PICO
Does coronary-artery stenting improve procedural success and event-free survival compared to standard coronary angioplasty in patients with isolated stenosis of the proximal left anterior descending coronary artery?
P
Population
120 patients with symptomatic isolated stenosis of the proximal left anterior descending coronary artery
I
Intervention
Coronary-artery stent implantation
C
Comparator
Standard coronary angioplasty
O
Outcome
Rate of procedural success (defined as residual stenosis of less than 50 percent and the absence of death, myocardial infarction, and the need for coronary-artery bypass surgery during the hospital stay) and the rate of event-free survival (defined as freedom from death, myocardial infarction, and the recurrence of angina) at 12 monthscomposite
In patients with isolated proximal LAD stenosis, coronary stenting significantly improves 12-month event-free survival and reduces restenosis compared to standard balloon angioplasty.
Cite This Study
Versaci et al. (1997) studied this question. Coronary stenting for proximal LAD stenosis improved 12-month event-free survival (87% vs 70%, P=0.04) and reduced restenosis (19% vs 40%, P=0.02) compared to standard angioplasty.