Unstable angina caused by monotruncular stenosis of the anterior interventricular artery (87 cases). Results of medical and surgical treatment

The aim of this study was to compare the medium-term results of medical therapy and aortocoronary bypass surgery in 87 patients selected on the following criteria: Clinical: unstable angina, defined as effort and/or resting angina appearing for the first time or increasing in severity within the previous 3 months, the last attack of chest pain occurring less than 8 days before admission to the Coronary Care Unit, with no signs of myocardial infarction before hospital admission and at coronary angiography. Coronary angiography: proximal isolated left anterior descending artery stenosis (greater than 70%). Thirty five patients were treated medically and 52 underwent coronary bypass surgery on the LAD artery: the results were compared at 18 and 24 months. Six patients were lost to follow-up, 2 from the medical group; the other 33 patients comprised group A. Four surgical patients were lost to follow-up, the other 48 patients comprised group B. The two groups had comparable clinical and epidemiological features. They differed in the incidence of hypertension which was more common in group A (p less than 0.01), in the better quality of the distal LAD artery in group B (p less than 0.01), and in the coexistence of less than 50% stenosis on the right coronary and left circumflex arteries which was commoner in group A (p less than 0.05). The mean follow-up period was comparable in the two groups (group A: 20.5 +/- 4.6 months; group B: 19.8 +/- 5.5 months).(ABSTRACT TRUNCATED AT 250 WORDS)