Management and Invasive Cardiological Review by Comparison of Percutaneous Coronary Intervention in Left Anterior
Majla Cibo1, Lejla Brigic1, Sanela Tukulija2
1Clinic for Heart Disease, Blood Vessels Diseases and Rheumatism; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Insights
Drug-eluting stents (DES) show better outcomes than bare-metal stents (BMS) for treating Left Anterior Descending (LAD) coronary artery disease, reducing restenosis and complications. This supports guidelines favoring DES for LAD interventions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Non-communicable diseases are a major global health concern.
- Heart and coronary artery diseases are a leading cause of death in Bosnia and Herzegovina (B&H).
- Prevention of cardiovascular diseases is crucial for public health improvement in B&H.
Purpose of the Study:
- To estimate one-year survival and left heart systolic function post-treatment for LAD disease.
- To identify patient profiles for Percutaneous Coronary Intervention with Drug-Eluting Stents (PCI DES) versus Bare-Metal Stents (PCI BMS) in LAD.
- To inform guidelines for more effective LAD treatment strategies.
Main Methods:
- Retrospective/prospective clinical study over three years.
- Inclusion of 60 patients followed for 12 months.
- Treatment allocation: 63.3% PCI BMS and 36.7% PCI DES in LAD.
Main Results:
- A statistically significant difference in complication rates between PCI DES and PCI BMS groups.
- Restenosis occurred in 75% of BMS cases, highlighting the advantage of DES.
- Disease progression in 2 patients underscores the need for risk factor management.
Conclusions:
- PCI DES is associated with fewer complications compared to PCI BMS for LAD disease.
- Drug-eluting stents are justified for LAD interventions due to lower restenosis rates.
- Ongoing monitoring and prevention of risk factors are essential for managing coronary artery disease progression.
Introduction:
The dominant global public health challenge are non-communicable diseases. According to World Health Organization (WHO) data. The fifth leading causes of death in FB&H are diseases of the heart and coronary arteries: stroke, acute myocardial infarction, cardiac arrest, cardiomyopathy and essential hypertension. The prevention of these diseases has great importance in improving health in B&H.
Objective:
The aim of this study is in estimation of one-year survival and left heart systolic function after the treatment. After the data collection and evidence of their statistical value, the results of the research point to the profile of patients with a LAD disease in one-vessel coronary artery disease that should be subjected to PCI DES LAD and PCI BMS LAD, respectively, or creating guidelines for a better and more effective LAD treatment.
Material And Methods:
The study was performed as retrospective/ prospective, clinically controlled for a period of three years. In this study was included 60 patients, which was followed in 12 months period. With the PCI BMS method was treated 63.3% and 36.7% of subjects were treated with the PCI DES in LAD.
Conclusion:
The number of complications in patients with one-vessel LAD coronary heart disease, treated with PCI DES and PCI BMS was statistically significant. One possible complication (4 patients) is due to the spread of the disease to other blood vessels. Due to possible complications in the treated or LAD with repeated stenosis, the complication in terms of restenosis of the previously placed stent in 75% are with BM stents justifying the use of drug eluting stent, while the progression of disease in patients (2 patients) indicates the need for detection and prevention of risk factors.
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