Single center experience in the treatment of hemodynamically significant diffuse coronary artery disease of the left anterior descending

To date there are no recommendations on how to treat patients with an FFR positive but diffusely diseased left anterior descending coronary artery (LAD). Benefit of coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is not so evident due to doubts regarding longevity...

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Bibliographic Details
Published in:International journal of cardiology 2022-04, Vol.352, p.40-44
Main Authors: van Beek, Konrad A.J., van Steenbergen, Gijs J., Vervaat, Fabienne E., Mulders, Bram C.J.H., van Straten, Bart H., van Nunen, Lokien X., Wijnbergen, Inge F.
Format: Article
Language:English
Subjects:
Canada
Coronary artery bypass grafting
Coronary artery disease
Coronary Artery Disease - diagnosis
Coronary Artery Disease - surgery
Diffuse disease
Fractional flow reserve
Humans
Optimal medical treatment
Percutaneous Coronary Intervention - adverse effects
Retrospective Studies
Treatment Outcome
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Summary:To date there are no recommendations on how to treat patients with an FFR positive but diffusely diseased left anterior descending coronary artery (LAD). Benefit of coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is not so evident due to doubts regarding longevity and patency. This retrospective single-center study assessed clinical outcomes in patients presenting with symptomatic single vessel coronary artery disease of a diffusely diseased, hemodynamically significant LAD treated by coronary artery bypass grafting (CABG) or optimal medical therapy (OMT) between 2015 and 2020. Primary outcome of this study was the composite endpoint of all-cause mortality, myocardial infarction and repeat revascularization during 2-year follow-up. Secondary endpoints consisted of the individual components of the primary endpoint. Change in angina severity grade based on the Canadian Cardiovascular Society (CCS) class between baseline and 2-year follow-up was assessed. Fifty-nine patients were included of which 25 patients underwent CABG and 34 patients were treated by OMT. There was a statistically significant difference in FFR value at baseline between the treatment groups (CABG 0.70 ± 0.04; OMT 0.75 ± 0.04; p 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2022.01.048