A study conducted at Cedars-Sinai Medical Center, however, suggests that angioplasty with coronary stenting may be a viable alternative treatment to more complicated bypass surgery for patients with left main coronary artery (LMCA) disease when medication-releasing stents are used. Introduced two years ago, these types of stents slowly release medication that helps to prevent reclosure of the coronary artery.
The study reports on the short- and intermediate-term clinical outcomes of 123 patients who underwent bypass surgery and 50 who were treated medically with angioplasty and medication-releasing stents, also called drug-eluding stents. None of the patients had prior bypass surgery.
"Despite the greater percentage of high risk patients in the group who underwent coronary stenting, there was no increase in the immediate or medium-term complications compared with the group treated with bypass surgery," said Raj Makkar, M.D., director of the Interventional Cardiology and Cardiac Catheterization Laboratory at Cedars-Sinai, and principal investigator on the study. According to Makkar, this is one of the first studies in the United States on the use of medicated stents for the treatment of LMCA disease. LMCA disease is found in five to seven percent of patients who undergo angiography.
The American College of Cardiology and the American Heart Association have discouraged the medical treatment of left main coronary artery disease based on poor clinical outcomes. The authors suggest that a re-evaluation of the optimal treatment for LMCA disease be considered based the results of this study and on recent data showing that angioplasty with drug-eluding stents provides better outcomes than
Contact: Sandy Van
Cedars-Sinai Medical Center