Natural history of left anterior descending coronary artery obstruction

Significance of location of stenoses in medically treated patients

J. K. Samaha, M. J. Connor, R. Tribble, F. W. Kroetz, J. M. Sullivan, K Ramanathan, D. M. Mirvis

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

We examined the prognostic significance of an obstructive lesion in the proximal left anterior descending (LAD) coronary artery. Five‐year or longer followup data were examined from 311 patients with >70% obstruction of the LAD treated without surgery. Mortality was compared in subsets with lesions proximal to and distal to the first septal perforating artery. Survival curves were worse in patients with proximal than with distal LAD disease (p<0.05); lesion location remained a significant determinant of survival when ejection fraction, age, and sex were controlled using a Cox regression model. However, when patient subsets were examined, survival with proximal LAD disease was worse than with distal obstruction only in the presence of an associated right coronary artery lesion and an ejection fraction of less than 40% (p<0.01). Patients with proximal LAD plus right coronary lesions had a 5‐year mortality rate (34.08 ± 8.9%) that was not significantly (p>0.05) different from that of a group of 66 patients with >50% narrowing of the left main coronary artery (24.02d̊4.3%). Thus, proximal LAD disease is more significant than is a distal lesion only in the presence of right coronary obstruction. This twovessel combination results in a mortality rate as high as that associated with left main coronary artery obstruction.

Original languageEnglish (US)
Pages (from-to)415-422
Number of pages8
JournalClinical Cardiology
Volume8
Issue number8
DOIs
StatePublished - Jan 1 1985

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Natural History
Coronary Vessels
Pathologic Constriction
Mortality
Arteries
Survival

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Natural history of left anterior descending coronary artery obstruction : Significance of location of stenoses in medically treated patients. / Samaha, J. K.; Connor, M. J.; Tribble, R.; Kroetz, F. W.; Sullivan, J. M.; Ramanathan, K; Mirvis, D. M.

In: Clinical Cardiology, Vol. 8, No. 8, 01.01.1985, p. 415-422.

Research output: Contribution to journalArticle

Samaha, J. K. ; Connor, M. J. ; Tribble, R. ; Kroetz, F. W. ; Sullivan, J. M. ; Ramanathan, K ; Mirvis, D. M. / Natural history of left anterior descending coronary artery obstruction : Significance of location of stenoses in medically treated patients. In: Clinical Cardiology. 1985 ; Vol. 8, No. 8. pp. 415-422.
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