Tags

Type your tag names separated by a space and hit enter

Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization.
J Am Coll Cardiol. 2008 Feb 05; 51(5):538-45.JACC

Abstract

OBJECTIVES

The purpose of this study was to compare the early and late results of percutaneous and surgical revascularization of left main coronary artery stenosis.

BACKGROUND

Unprotected left main coronary artery (ULMCA) stenting is being investigated as an alternative to bypass surgery.

METHODS

We randomly assigned 105 patients with ULMCA stenosis to percutaneous coronary intervention (PCI; 52 patients) or coronary artery bypass grafting (CABG; 53 patients). The primary end point was the change in left ventricular ejection fraction (LVEF) 12 months after the intervention. Secondary end points included 30-day major adverse events (MAE), major adverse cardiac and cerebrovascular events (MACCE), length of hospitalization, target vessel failure (TVF), angina severity and exercise tolerance after 1 year, and total and MACCE-free survival.

RESULTS

A significant increase in LVEF at the 12-month follow-up was noted only in the PCI group (3.3 +/- 6.7% after PCI vs. 0.5 +/- 0.8% after CABG; p = 0.047). Patients performed equally well on stress tests, and angina status improved similarly in the 2 groups. PCI was associated with a lower 30-day risk of MAE (p < 0.006) and MACCE (p = 0.03) and shorter hospitalizations (p = 0.0007). Total and MACCE-free 1-year survival was comparable. Left main TVF was similar in the 2 groups. During the 28.0 +/- 9.9-month follow-up, there were 3 deaths in the PCI group and 7 deaths in the CABG group (p = 0.08).

CONCLUSIONS

Patients with ULMCA disease treated with PCI had favorable early outcomes in comparison with the CABG group. At 1 year, LVEF had improved significantly only in the PCI group. After more than 2 years, MACCE-free survival was similar in both groups with a trend toward improved survival after PCI.

Authors+Show Affiliations

Medical University of Silesia, Katowice, Poland. pbuszman@ka.onet.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18237682

Citation

Buszman, Pawel E., et al. "Acute and Late Outcomes of Unprotected Left Main Stenting in Comparison With Surgical Revascularization." Journal of the American College of Cardiology, vol. 51, no. 5, 2008, pp. 538-45.
Buszman PE, Kiesz SR, Bochenek A, et al. Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization. J Am Coll Cardiol. 2008;51(5):538-45.
Buszman, P. E., Kiesz, S. R., Bochenek, A., Peszek-Przybyla, E., Szkrobka, I., Debinski, M., Bialkowska, B., Dudek, D., Gruszka, A., Zurakowski, A., Milewski, K., Wilczynski, M., Rzeszutko, L., Buszman, P., Szymszal, J., Martin, J. L., & Tendera, M. (2008). Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization. Journal of the American College of Cardiology, 51(5), 538-45. https://doi.org/10.1016/j.jacc.2007.09.054
Buszman PE, et al. Acute and Late Outcomes of Unprotected Left Main Stenting in Comparison With Surgical Revascularization. J Am Coll Cardiol. 2008 Feb 5;51(5):538-45. PubMed PMID: 18237682.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization. AU - Buszman,Pawel E, AU - Kiesz,Stefan R, AU - Bochenek,Andrzej, AU - Peszek-Przybyla,Ewa, AU - Szkrobka,Iwona, AU - Debinski,Marcin, AU - Bialkowska,Bozena, AU - Dudek,Dariusz, AU - Gruszka,Agata, AU - Zurakowski,Aleksander, AU - Milewski,Krzysztof, AU - Wilczynski,Miroslaw, AU - Rzeszutko,Lukasz, AU - Buszman,Piotr, AU - Szymszal,Jan, AU - Martin,Jack L, AU - Tendera,Michal, PY - 2007/03/21/received PY - 2007/09/10/revised PY - 2007/09/17/accepted PY - 2008/2/2/pubmed PY - 2008/2/8/medline PY - 2008/2/2/entrez SP - 538 EP - 45 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 51 IS - 5 N2 - OBJECTIVES: The purpose of this study was to compare the early and late results of percutaneous and surgical revascularization of left main coronary artery stenosis. BACKGROUND: Unprotected left main coronary artery (ULMCA) stenting is being investigated as an alternative to bypass surgery. METHODS: We randomly assigned 105 patients with ULMCA stenosis to percutaneous coronary intervention (PCI; 52 patients) or coronary artery bypass grafting (CABG; 53 patients). The primary end point was the change in left ventricular ejection fraction (LVEF) 12 months after the intervention. Secondary end points included 30-day major adverse events (MAE), major adverse cardiac and cerebrovascular events (MACCE), length of hospitalization, target vessel failure (TVF), angina severity and exercise tolerance after 1 year, and total and MACCE-free survival. RESULTS: A significant increase in LVEF at the 12-month follow-up was noted only in the PCI group (3.3 +/- 6.7% after PCI vs. 0.5 +/- 0.8% after CABG; p = 0.047). Patients performed equally well on stress tests, and angina status improved similarly in the 2 groups. PCI was associated with a lower 30-day risk of MAE (p < 0.006) and MACCE (p = 0.03) and shorter hospitalizations (p = 0.0007). Total and MACCE-free 1-year survival was comparable. Left main TVF was similar in the 2 groups. During the 28.0 +/- 9.9-month follow-up, there were 3 deaths in the PCI group and 7 deaths in the CABG group (p = 0.08). CONCLUSIONS: Patients with ULMCA disease treated with PCI had favorable early outcomes in comparison with the CABG group. At 1 year, LVEF had improved significantly only in the PCI group. After more than 2 years, MACCE-free survival was similar in both groups with a trend toward improved survival after PCI. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18237682/Acute_and_late_outcomes_of_unprotected_left_main_stenting_in_comparison_with_surgical_revascularization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)03608-X DB - PRIME DP - Unbound Medicine ER -