Abstract 3680: Comparison of Intracoronary Stenting Versus Medical Therapy in Patients with Symptomatic Myocardial Bridging
INTRODUCTION: Medical therapy is the first line therapy for patients with symptomatic myocardial bridging, with surgical intervention being reserved for select pts with refractory symptoms. Limited data exist on the outcome of intra-coronary stenting (ICS) in this patient cohort.
OBJECTIVE: To compare the long-term results of ICS in pts with symptomatic myocardial bridging to medical therapy.
METHODS: We conducted a single-center, retrospective study evaluating all pts between 10/03 and 12/05 with anginal symptoms and myocardial bridging of the left anterior descending (LAD) artery of >50% systolic compression as determined by quantitative coronary analysis. Canadian Cardiology Society (CCS) class of angina, target vessel revascularization (TVR), myocardial infarction (MI) and death were evaluated in all pts.
RESULTS: 28 patients were identified. Sixteen (56%) pts were treated with maximal medical therapy (Group A), while 12 (44%) pts were treated with ICS, 4 receiving bare metal stents (BMS) and 8 receiving drug-eluting stents (DES) (Group B). The mean age of the cohort was 51 years (29–80 yr). Clinical characteristics, including baseline CCS angina class, were similar between the two groups. All patients in Group A were compliant with medications and procedural success was 100% in patients in group B. Outcome results are presented in Table⇓. TVR was 75% after BMS and 13% after DES placement.
CONCLUSION: Coronary stenting in the setting of symptomatic myocardial bridging is associated with a higher incidence of recurrent angina and TVR compared to medical therapy, particularly in patients receiving BMS. Therefore, medical therapy remains the preferred approach for patients with symptomatic myocardial bridging. DES should be reserved for pts with refractory symptoms despite maximal medical therapy. Table⇓. Outcomes of patients treated medically (Group A) versus with ICS (Group B).