Comparison of balloon angioplasty , stent insertion and medical therapy in the treatment of single LAD lesion / 대한내과학회지

ABSTRACT

With recent advances in transarterial interventional technique, there is a tendency to treat single LAD lesion with balloon angioplasty or stent insertion rather than with medical therapy alone. Therefore, it is important to evaluate the long-term clinical outcomes of such interventional therapy. METHODS: Subjects are comprised of patients who underwent coronary angiogram from 1993 to 1996 and diagnosed as having single LAD lesion without decrease of left ventricular fuction. The incidence of major ischemic complications, revascularization and reduction of angina pectoris after different therapeutic strategies in these patients are evaluated. RESULT: 1) There was total of 190 patients. Patients receiving medical therapy, balloon angioplasty and stent insertion were 70, 75, and 45 respectively. There was no significant difference in mean age, sex ratio, and risk factors of coronary artery occlusive disease between each groups. 2) The medical therapy group(30%) had a significantly lower incidence of proximal stenosis lesion compared to the balloon angioplasty group (45%) and stent insertion group(52%) according to the location of the lesion(p0.05). CONCLUSION: For patients with single LAD stenotic lesion interventional therapies such as balloon angioplasty and stent insertion might be more effective without statistical signigicance in reducing chest pain compared to medical therapy. There was no significant difference in the incidence of ischemic complication and rate of revascularization among different study groups. Further studies will be needed to clarify the beneficial effects of interventional coronary artery therapy such as improvement of chest pain, increased exercise capacity, and improved quality of life along with other parameters.