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Coronary artery bypass grafting versus drug-eluting stent implantation for left main coronary artery disease (from a two-center registry).
Am J Cardiol. 2010 Feb 01; 105(3):343-51.AJ

Abstract

Recent studies have suggested that percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery (LMCA) disease renders outcomes comparable to those from coronary artery bypass grafting (CABG). It is necessary to stratify individual patient risk and select the optimal revascularization strategy. We compared the clinical outcomes of patients with unprotected LMCA disease who had undergone PCI with drug-eluting stents or CABG. We identified 462 patients who were treated from January 2003 to December 2006 for unprotected LMCA or LMCA-equivalent disease: 257 had undergone CABG and 205 had undergone PCI with drug-eluting stents. Analyses using propensity scores were performed to minimize the selection bias in the present observational study. After a median follow-up of 33.5 months, no significant difference was found between the CABG and PCI groups in the risk of death (12.1% vs 14.1%, respectively; p = 0.428) or the risk of a composite of death, myocardial infarction, or cerebrovascular accident (17.5% vs 20.0%, respectively; p = 0.434). The rate of major adverse cardiac and cerebrovascular events was significantly lower in the CABG group than in the PCI group (21.8% vs 35.1%, respectively; p = 0.001); the difference was mainly driven by a decrease in the rate of repeat revascularizations (5.1% vs 22.4%; p <0.001). The analyses after propensity score adjustment and matching corroborated the crude group results. In conclusion, PCI with drug-eluting stents showed a safety profile comparable to that of CABG in patients with unprotected LMCA disease. However, the risk of repeat revascularization was significantly greater in the PCI group.

Authors+Show Affiliations

Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.No 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
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20102946

Citation

Kang, Si-Hyuck, et al. "Coronary Artery Bypass Grafting Versus Drug-eluting Stent Implantation for Left Main Coronary Artery Disease (from a Two-center Registry)." The American Journal of Cardiology, vol. 105, no. 3, 2010, pp. 343-51.
Kang SH, Park KH, Choi DJ, et al. Coronary artery bypass grafting versus drug-eluting stent implantation for left main coronary artery disease (from a two-center registry). Am J Cardiol. 2010;105(3):343-51.
Kang, S. H., Park, K. H., Choi, D. J., Park, K. W., Chung, W. Y., Lim, C., Kim, K. B., & Kim, H. S. (2010). Coronary artery bypass grafting versus drug-eluting stent implantation for left main coronary artery disease (from a two-center registry). The American Journal of Cardiology, 105(3), 343-51. https://doi.org/10.1016/j.amjcard.2009.09.036
Kang SH, et al. Coronary Artery Bypass Grafting Versus Drug-eluting Stent Implantation for Left Main Coronary Artery Disease (from a Two-center Registry). Am J Cardiol. 2010 Feb 1;105(3):343-51. PubMed PMID: 20102946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary artery bypass grafting versus drug-eluting stent implantation for left main coronary artery disease (from a two-center registry). AU - Kang,Si-Hyuck, AU - Park,Kay-Hyun, AU - Choi,Dong-Ju, AU - Park,Kyung Woo, AU - Chung,Woo-Young, AU - Lim,Cheong, AU - Kim,Ki-Bong, AU - Kim,Hyo-Soo, PY - 2009/07/15/received PY - 2009/09/22/revised PY - 2009/09/22/accepted PY - 2010/1/28/entrez PY - 2010/1/28/pubmed PY - 2010/3/2/medline SP - 343 EP - 51 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 105 IS - 3 N2 - Recent studies have suggested that percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery (LMCA) disease renders outcomes comparable to those from coronary artery bypass grafting (CABG). It is necessary to stratify individual patient risk and select the optimal revascularization strategy. We compared the clinical outcomes of patients with unprotected LMCA disease who had undergone PCI with drug-eluting stents or CABG. We identified 462 patients who were treated from January 2003 to December 2006 for unprotected LMCA or LMCA-equivalent disease: 257 had undergone CABG and 205 had undergone PCI with drug-eluting stents. Analyses using propensity scores were performed to minimize the selection bias in the present observational study. After a median follow-up of 33.5 months, no significant difference was found between the CABG and PCI groups in the risk of death (12.1% vs 14.1%, respectively; p = 0.428) or the risk of a composite of death, myocardial infarction, or cerebrovascular accident (17.5% vs 20.0%, respectively; p = 0.434). The rate of major adverse cardiac and cerebrovascular events was significantly lower in the CABG group than in the PCI group (21.8% vs 35.1%, respectively; p = 0.001); the difference was mainly driven by a decrease in the rate of repeat revascularizations (5.1% vs 22.4%; p <0.001). The analyses after propensity score adjustment and matching corroborated the crude group results. In conclusion, PCI with drug-eluting stents showed a safety profile comparable to that of CABG in patients with unprotected LMCA disease. However, the risk of repeat revascularization was significantly greater in the PCI group. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/20102946/Coronary_artery_bypass_grafting_versus_drug_eluting_stent_implantation_for_left_main_coronary_artery_disease__from_a_two_center_registry__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02407-2 DB - PRIME DP - Unbound Medicine ER -