Long-term clinical outcome following coronary artery bypass grafting for isolated stenosis of the left anterior descending coronary artery

Aims To detail the clinical and angiographic profile, and long-term outcome in consecutive patients with isolated stenosis of the left anterior descending coronary artery undergoing bypass surgery. Methods A retrospective study of all patients (n=301) (January 1984‐December 1990) and undergoing coronary artery bypass grafting for isolated left anterior descending disease, in the Irish Republic, was performed. Survival was compared with that of an exact age- and gender-matched cohort. Results Mean age was 53 (&9·3) years. There were 238 (79%) males. In 241 (80%) patients an internal thoracic arterial bypass graft was used. Operative mortality was 1·3%. Of the 280 (93%) patients alive (16 cardiac deaths) at 7·1 (&1·9) years, 105 (35%) had angina, 26 (9%) suVered an interval myocardial infarction, and repeat revascularization was required on 29 (10%). Female gender (P=0·002), pre-operative myocardial infarction (P=0·02), significant diagonal disease (P=0·04) and postoperative myocardial infarction (P=0·0001) were independently associated with survival. Females were more likely to develop congestive cardiac failure (P=0·01) or postoperative angina (P=0·03) than their male counterparts. Conclusions Survivorship (97%) and event-free survival (96%) at 5 years following coronary artery bypass grafting for isolated left anterior descending coronary artery disease is excellent and equivalent to an age-matched and gendermatched cohort. (Eur Heart J 1998; 19: 447‐457)