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Clinical Trial
. 2003 Feb;89(2):184-8.
doi: 10.1136/heart.89.2.184.

Coronary stenting versus coronary bypass surgery in patients with multiple vessel disease and significant proximal LAD stenosis: results from the ERACI II study

A Rodriguez  1 , M Rodríguez Alemparte, J Baldi, J Navia, A Delacasa, D Vogel, R Oliveri, C Fernández Pereira, V Bernardi, W O'Neill, I F Palacios
Affiliations
Clinical Trial

Coronary stenting versus coronary bypass surgery in patients with multiple vessel disease and significant proximal LAD stenosis: results from the ERACI II study

A Rodriguez et al. Heart. 2003 Feb.

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.

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Figures

Figure 1
Figure 1
Kaplan-Meier curve showing survival at follow up of patients with ostial or proximal left anterior descending (LAD) coronary artery randomly assigned to undergo percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG).
Figure 2
Figure 2
Kaplan-Meier curve showing freedom from death and myocardial infarction of patients with ostial or proximal LAD randomly assigned to undergo PCI or CABG.
Figure 3
Figure 3
Kaplan-Meier curve showing freedom from repeat PCI or CABG of patients with ostial or proximal LAD randomly assigned to undergo PCI or CABG.
Figure 4
Figure 4
Kaplan-Meier curve showing freedom from major adverse cardiac events (death, myocardial infarction, stroke, and repeat PCI or CABG) of patients with ostial or proximal LAD randomly assigned to undergo PCI or CABG.
See this image and copyright information in PMC

References

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