Coronary stenting versus coronary bypass surgery in patients with multiple vessel disease and significant proximal LAD stenosis: results from the ERACI II study. Issue 2 (1st February 2003)

• Record Type: Journal Article
• Authors: Rodriguez, A; Rodríguez Alemparte, M; Baldi, J; Navia, J; Delacasa, A; Vogel, D; Oliveri, R; Fernández Pereira, C; Bernardi, V; O'Neill, W; Palacios, I F
• Is Part Of: Heart. Volume 89:Issue 2(2003)
• Page Start: 184
• Page End: 188
• Publication Date: 2003-02-01
• Subjects: coronary artery bypass -- proximal LAD intervention -- multivessel coronary stenting -- multivessel revascularisation; ARTS, artery revascularization strategy study -- BARI, bypass angioplasty revascularization investigation -- CABG, coronary artery bypass graft -- ERACI, Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease -- LAD, left anterior descending coronary artery -- PCI, percutaneous coronary intervention -- PTCA, percutaneous transluminal coronary angioplasty, SOS, stent or surgery; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heart.89.2.184
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Purpose: To compare percutaneous coronary intervention (PCI) using stent implantation versus coronary artery bypass graft (CABG) in patients with multiple vessel disease with involvement of the proximal left anterior descending coronary artery (LAD). Methods: 230 patients with multiple vessel disease and severe stenosis of the proximal LAD (113 with PCI, 117 with CABG). They were a cohort of patients from the randomised ERACI (Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease) II study. Results: Both groups had similar baseline characteristics. There were no significant differences in 30 day major adverse cardiac events (death, myocardial infarction, stroke, and repeat procedures) between the strategies (PCI 2.7% v CABG 7.6%, p = 0.18). There were no significant differences in survival (PCI 96.4% v CABG 95%, p = 0.98) and survival with freedom from myocardial infarction (PCI 92% v CABG 89%, p = 0.94) at 41.5 (6) months' follow up. However, freedom from new revascularisation procedures (CABG 96.6% v PCI 73%, p = 0.0002) and frequency of angina (CABG 9.4% v PCI 22%, p = 0.025) were superior in the CABG group. Conclusion: Patients with multivessel disease and significant disease of the proximal LAD randomly assigned in the ERACI II trial to PCI or CABG had similar survival and survival with freedom from myocardial infarction at long term follow up. Repeat revascularisation procedures were higher in the PCI group.