Kinnaird, T and Anderson, R and Ossei-Gerning, N and Mamas, M and Ludman, P and Moat, N (2016) Revascularization for Left Anterior Descending Artery Stenosis: A Review of the Evidence That Supports Practice. Cardiology in Review. ISSN 1061-5377
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Disease of the proximal left anterior descending (LAD) artery is a common pathological finding often combined with disease in other coronary arteries. In this article we review specifically the evidence (and the guidelines arising from the data) for lesions isolated to the proximal LAD only. Critical review of the data reveals limitations with few trials that reflect contemporary practice. Much of the data are observational rather than from randomized trials, and therefore subject to bias. We identified two randomized trials of drug-eluting stents versus left internal mammary artery grafting for isolated lesions of the proximal LAD. One reported no difference in major adverse cardiovascular events, but at an early time-point (6-months), which is likely to be too early to reveal treatment differences. In the second trial, target lesion revascularization excess was noted in the drug-eluting stent arm. Therefore, at the current time, there is little data available to inform interventional cardiologists as to the best revascularization strategy for isolated lesions of the proximal LAD. Further randomized, controlled trials are needed.
|Additional Information:||Authors' final peer-reviewed manuscript published in final form (online) 12 January 2016 of Kinnaird, T. et al., 2015. Revascularization for Left Anterior Descending Artery Stenosis. Cardiology in Review, p.1. Available at: http://dx.doi.org/10.1097/crd.0000000000000097|
|Uncontrolled Keywords:||Proximal left anterior descending artery, left internal mammary artery, drug eluting stent, bare metal stent, percutaneous coronary intervention, coronary artery bypass grafting|
|Subjects:||R Medicine > R Medicine (General)|
|Divisions:||Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine|
|Date Deposited:||12 Jan 2016 12:03|
|Last Modified:||12 Jan 2017 01:30|
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