[Long-term follow-up of patients with proximal left anterior descending coronary artery stenosis treated with stent]. / Seguimiento a largo plazo de pacientes con estenosis de la arteria coronaria descendente anterior proximal tratadas con stent.

ABSTRACT

INTRODUCTION AND OBJECTIVE: Patients with lesions of the proximal left anterior descending coronary artery are a special high-risk group. In the present study we analyzed the efficacy and safety of coronary stenting in such lesions and the factors related to a less favorable prognosis in long-term follow-up. METHODS: Ninety-eight consecutive patients with severe left anterior descending artery stenosis were enrolled, all with coronary angioplasty and elective stenting. Clinical follow-up was carried out annually in all patients by personal interview or telephone contact. The incidence of death, new infarction, anginal status, and new revascularization procedures was registered. Clinical, angiographic, and procedural variables were analyzed to identify predictors of long term prognosis. RESULTS: Mean follow-up was 38 11 months. There was only one major periprocedural complication, which required urgent surgery. Five deaths were registered, 3 of non-cardiac and 2 of cardiac origin. Twenty-five patients developed angina and 11 underwent a new revascularization of the proximal left anterior descending coronary artery (6 surgical and 5 angioplasty). Two patients had new anterior myocardial infarction. At 60 months the major cardiac event-free rate was 83.7% and the cardiac death-free rate was 98%. The use of two stents and the association of diabetes-hypertension-hypercholesterolemia were associated with a less favorable prognosis in our population. CONCLUSIONS: Stenting of left anterior descending coronary stenosis was safe and effective in a long-term analysis. The survival rate was high and the incidence of new revascularization was low.