title: Drug eluting stents versus coronary artery bypass surgery in patients with isolated proximal lesion in left anterior descending artery suffering from chronic stable angina.
abstract: OBJECTIVE
  To compare the efficacy of drug eluting stents (DES) compared with bypass surgery (CABG) with left internal mammary artery (LIMA) in patients with single vessel disease suffering from chronic stable angina.
  
  
  BACKGROUND
  There are a limited number of studies investigating this group of patients.
  
  
  METHODS
  We included 257 consecutive patients with isolated lesion in the proximal segment of left anterior descending artery (LAD). All patients suffered from chronic stable angina or from stress-induced ischemia. Of 257 patients, 147 underwent DES implantation and 110 CABG with LIMA. All patients were followed-up clinically for major adverse cardiac events.
  
  
  RESULTS
  The baseline demographic and angiographic characteristics were similar between the two groups. In the DES group we used sirolimus-, paclitaxel-, and ABT-578-eluting stents. The mean duration of hospitalization after CABG was 7.86 +/- 3.84 days vs. 1.02 +/- 0.19 days after PCI (P < 0.01). The incidence of MACE was 2.72% in the DES and 2.72% in the surgical group during a mean follow-up period of 18.71 +/- 6.27 months for PCI and 18.70 +/- 7.31 months for CABG (P = 0.99). There was one cardiac related death in the DES group and two in the surgical group (P = 0.58). There were three reinterventions in the DES group versus none in the surgical group (P = 0.26). Recurrence of angina was observed in 4.08% of pts in the DES group versus 6.36% in the CABG group (P = 0.57).
  
  
  CONCLUSIONS
  The present study demonstrated that patients suffering from chronic stable angina with isolated lesion in the proximal segment of LAD have excellent long-term outcome in both surgical and DES treatment.
authors.affiliation: First Department of Cardiology, Athens Medical School, Athens, Greece. ktoutouz@otenet.gr
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Patsa
authors.forename: Sophia
authors.initials: S
authors.lastname: Vaina
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiamis
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.forename: Elli
authors.initials: E
authors.lastname: Stefanadi
authors.forename: Anastasios
authors.initials: A
authors.lastname: Spanos
authors.forename: Dimitiros
authors.initials: D
authors.lastname: Iliopoulos
authors.forename: Mathaios
authors.initials: M
authors.lastname: Panagiotou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Chlorogiannis
authors.forename: Eustratios
authors.initials: E
authors.lastname: Pattakos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery*; D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002908:Chronic Disease; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology; D020123:Sirolimus / Q000031:analogs & derivatives / Q000494:pharmacology; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus