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Coronary angioplasty in drug eluting stent era for the treatment of unprotected left main stenosis compared to coronary artery bypass grafting.
Ann Med. 2008; 40(6):437-43.AM

Abstract

BACKGROUND

Improved outcomes of percutaneous coronary interventions (PCI) with drug-eluting stents (DES) have resulted in their expanded use for left main coronary artery (LMCA) stenosis.

AIM

We compared outcomes of patients undergoing PCI for unprotected LMCA stenosis and patients treated by coronary artery bypass grafting (CABG).

METHOD

Between January 2005 and January 2007, 6705 patients were studied with coronary angiography in northern Finland. All subjects treated with revascularization of LMCA stenosis (n = 287) were included and followed up for a mean of 12+6 months.

RESULTS

From 287 patients, 238 underwent CABG, and 49 had PCI with DES. The incidence of 1-year mortality was 4% among the PCI-treated and 11% among CABG-treated patients (P = 0.136). After the first month, mortality among PCI-or CABG-treated patients did not differ statistically significantly (2% versus 7%, P = 0.133). The most significant independent predictor of mortality was reduced left ventricular systolic function (hazard ratio 14.9, 95% CI 5.5-40.0, P < 0.001).

CONCLUSIONS

PCI with DES for selected LMCA disease patients results in short- and midterm outcomes comparable to results of CABG in general. PCI is a viable therapeutic option in selected patients with LMCA stenosis.

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Publisher Full Text

Authors+Show Affiliations

Mäkikallio TH
Division of Cardiology, Department of Internal Medicine, University of Oulu, Lapland Central Hospital, Rovaniemi, Finland. timo.makikallio@oulu.fi
Niemelä M
No affiliation info available
Kervinen K
No affiliation info available
Jokinen V
No affiliation info available
Laukkanen J
No affiliation info available
Ylitalo I
No affiliation info available
Tulppo MP
No affiliation info available
Juvonen J
No affiliation info available
Huikuri HV
No affiliation info available

MeSH

AgedAged, 80 and overAngioplasty, Balloon, CoronaryCoronary Artery BypassCoronary StenosisDrug-Eluting StentsFemaleHumansKaplan-Meier EstimateMaleMiddle AgedRetrospective Studies

Pub Type(s)

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

Language

eng

PubMed ID

18608116

Citation

Mäkikallio, Timo H., et al. "Coronary Angioplasty in Drug Eluting Stent Era for the Treatment of Unprotected Left Main Stenosis Compared to Coronary Artery Bypass Grafting." Annals of Medicine, vol. 40, no. 6, 2008, pp. 437-43.
Mäkikallio TH, Niemelä M, Kervinen K, et al. Coronary angioplasty in drug eluting stent era for the treatment of unprotected left main stenosis compared to coronary artery bypass grafting. Ann Med. 2008;40(6):437-43.
Mäkikallio, T. H., Niemelä, M., Kervinen, K., Jokinen, V., Laukkanen, J., Ylitalo, I., Tulppo, M. P., Juvonen, J., & Huikuri, H. V. (2008). Coronary angioplasty in drug eluting stent era for the treatment of unprotected left main stenosis compared to coronary artery bypass grafting. Annals of Medicine, 40(6), 437-43. https://doi.org/10.1080/07853890701879790
Mäkikallio TH, et al. Coronary Angioplasty in Drug Eluting Stent Era for the Treatment of Unprotected Left Main Stenosis Compared to Coronary Artery Bypass Grafting. Ann Med. 2008;40(6):437-43. PubMed PMID: 18608116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary angioplasty in drug eluting stent era for the treatment of unprotected left main stenosis compared to coronary artery bypass grafting. AU - Mäkikallio,Timo H, AU - Niemelä,Matti, AU - Kervinen,Kari, AU - Jokinen,Vesa, AU - Laukkanen,Jari, AU - Ylitalo,Ikari, AU - Tulppo,Mikko P, AU - Juvonen,Jukka, AU - Huikuri,Heikki V, PY - 2008/7/9/pubmed PY - 2009/3/21/medline PY - 2008/7/9/entrez SP - 437 EP - 43 JF - Annals of medicine JO - Ann Med VL - 40 IS - 6 N2 - BACKGROUND: Improved outcomes of percutaneous coronary interventions (PCI) with drug-eluting stents (DES) have resulted in their expanded use for left main coronary artery (LMCA) stenosis. AIM: We compared outcomes of patients undergoing PCI for unprotected LMCA stenosis and patients treated by coronary artery bypass grafting (CABG). METHOD: Between January 2005 and January 2007, 6705 patients were studied with coronary angiography in northern Finland. All subjects treated with revascularization of LMCA stenosis (n = 287) were included and followed up for a mean of 12+6 months. RESULTS: From 287 patients, 238 underwent CABG, and 49 had PCI with DES. The incidence of 1-year mortality was 4% among the PCI-treated and 11% among CABG-treated patients (P = 0.136). After the first month, mortality among PCI-or CABG-treated patients did not differ statistically significantly (2% versus 7%, P = 0.133). The most significant independent predictor of mortality was reduced left ventricular systolic function (hazard ratio 14.9, 95% CI 5.5-40.0, P < 0.001). CONCLUSIONS: PCI with DES for selected LMCA disease patients results in short- and midterm outcomes comparable to results of CABG in general. PCI is a viable therapeutic option in selected patients with LMCA stenosis. SN - 0785-3890 UR - https://www.unboundmedicine.com/medline/citation/18608116/Coronary_angioplasty_in_drug_eluting_stent_era_for_the_treatment_of_unprotected_left_main_stenosis_compared_to_coronary_artery_bypass_grafting_ L2 - https://www.tandfonline.com/doi/full/10.1080/07853890701879790 DB - PRIME DP - Unbound Medicine ER -
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