Long-term clinical outcome following coronary artery bypass grafting for isolated stenosis of the left anterior descending coronary artery

Eur Heart J. 1998 Mar;19(3):447-57. doi: 10.1053/euhj.1997.0775.

Abstract

Aims: To detail the clinical and angiographic profile, and long-term outcome in consecutive patients with isolated stenosis of the left anterior descending coronary artery undergoing bypass surgery.

Methods: A retrospective study of all patients (n = 301) (January 1984-December 1990) and undergoing coronary artery bypass grafting for isolated left anterior descending disease, in the Irish Republic, was performed. Survival was compared with that of an exact age- and gender-matched cohort.

Results: Mean age was 53 (+/- 9.3) years. There were 238 (79%) males. In 241 (80%) patients an internal thoracic arterial bypass graft was used. Operative mortality was 1.3%. Of the 280 (93%) patients alive (16 cardiac deaths) at 7.1 (+/- 1.9) years, 105 (35%) had angina, 26 (9%) suffered an interval myocardial infarction, and repeat revascularization was required on 29 (10%). Female gender (P = 0.002), pre-operative myocardial infarction (P = 0.02), significant diagonal disease (P = 0.04) and postoperative myocardial infarction (P = 0.0001) were independently associated with survival. Females were more likely to develop congestive cardiac failure (P = 0.01) or postoperative angina (P = 0.03) than their male counterparts.

Conclusions: Survivorship (97%) and event-free survival (96%) at 5 years following coronary artery bypass grafting for isolated left anterior descending coronary artery disease is excellent and equivalent to an age-matched and gender-matched cohort.

MeSH terms

  • Adult
  • Angioplasty, Balloon, Coronary
  • Coronary Angiography
  • Coronary Artery Bypass*
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / mortality
  • Coronary Disease / surgery*
  • Female
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome