TY - JOUR T1 - Comparison of coronary artery bypass surgery with percutaneous coronary intervention with drug-eluting stents for unprotected left main coronary artery disease. AU - Lee,Michael S, AU - Kapoor,Nikhil, AU - Jamal,Faizi, AU - Czer,Lawrence, AU - Aragon,Joseph, AU - Forrester,James, AU - Kar,Saibal, AU - Dohad,Suhail, AU - Kass,Robert, AU - Eigler,Neal, AU - Trento,Alfredo, AU - Shah,Prediman K, AU - Makkar,Raj R, Y1 - 2006/01/06/ PY - 2005/06/16/received PY - 2005/08/10/revised PY - 2005/09/08/accepted PY - 2006/2/21/pubmed PY - 2006/4/29/medline PY - 2006/2/21/entrez SP - 864 EP - 70 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 47 IS - 4 N2 - OBJECTIVES: This study evaluated the clinical outcomes of consecutive, selected patients treated with coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main coronary artery (ULMCA) disease. BACKGROUND: Although recent data suggest that PCI with DES provides better clinical outcomes compared to bare-metal stenting for ULMCA disease, there is a paucity of data comparing PCI with DES to CABG. METHODS: Since April 2003, when DES first became available at our institution, 123 patients underwent CABG, and 50 patients underwent PCI with DES for ULMCA disease. RESULTS: High-risk patients (Parsonnet score >15) comprised 46% of the CABG group and 64% of the PCI group (p = 0.04). The 30-day major adverse cardiac and cerebrovascular event (MACCE) rate for CABG and PCI was 17% and 2% (p < 0.01), respectively. The mean follow-up was 6.7 +/- 6.2 months in the CABG group and 5.6 +/- 3.9 months in the PCI group (p = 0.26). The estimated MACCE-free survival at six months and one year was 83% and 75% in the CABG group versus 89% and 83% in the PCI group (p = 0.20). By multivariable Cox regression, Parsonnet score, diabetes, and CABG were independent predictors of MACCE. CONCLUSIONS: Despite a higher percentage of high-risk patients, PCI with DES for ULMCA disease was not associated with an increase in immediate or medium-term complications compared with CABG. Our data suggest that a randomized comparison between the two revascularization strategies for ULMCA may be warranted. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/16487857/Comparison_of_coronary_artery_bypass_surgery_with_percutaneous_coronary_intervention_with_drug_eluting_stents_for_unprotected_left_main_coronary_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(05)03037-8 DB - PRIME DP - Unbound Medicine ER -