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Clinical Trial Summary

The Nordic-Baltic Heart Team Initiative for improved long-term coronary artery revascularization outcome compares quality of life and survival after coronary bypass grafting (CABG) vs. percutaneous coronary intervention (PCI) in patients with 1-vessel disease and proximal stenosis of the anterior descending artery (LAD/in patients with isolated proximal left descending coronary artery (LAD) lesion


Clinical Trial Description

It is not clear how operable 1-VD patients with stable or stabilized coronary artery disease involving a pLAD lesion should be treated to optimize long-term survival and quality of life. According to recent European guidelines, significant pLAD disease may be treated by PCI or by CABG. This recommendation is based on two meta-analyses including 1.210 and 1.952 randomized and non-randomized patients. Generally, the patients were followed for 4-5 years. The analyses reported similar rates of mortality, MI and stroke, but more repeat revascularizations after PCI. Only one study including129 patients provided more than 5-year follow-up. Thus, the there is limited documentation for long-term effect of PCI vs. surgical re-vascularization in pLAD disease. The American 2014 Guidelines on coronary revascularization recommends CABG for improved survival in patients with solitary proximal LAD stenosis. CABG The angiographic 90% LIMA patency rate after 1, 2 and 3 decades is well described and suggestive of a survival benefit of surgical revascularization. Therefore, there is scientific background for an CABG LIMA-to-LAD vs. PCI comparison in 1-VD patients with a pLAD lesion. Substantiated expectations: - PCI is superior to bypass operation concerning short-term quality of life. - Off-pump LIMA-to-LAD is superior to PCI concerning long-term all-cause mortality. - Long-term (≥10-year) follow-up is essential to evaluate coronary revascularization strategies. - Outcome may be dependent on lesion complexity, diabetes and gender. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03538886
Study type Interventional
Source Aalborg University Hospital
Contact
Status Terminated
Phase N/A
Start date June 1, 2018
Completion date July 31, 2019

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