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10-Year Outcomes of Stents Versus Coronary Artery Bypass Grafting for Left Main Coronary Artery Disease

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dc.contributor.authorPark, DW-
dc.contributor.authorAhn, JM-
dc.contributor.authorYun, SC-
dc.contributor.authorYoon, YH-
dc.contributor.authorKang, DY-
dc.contributor.authorLee, PH-
dc.contributor.authorLee, SW-
dc.contributor.authorPark, SW-
dc.contributor.authorSeung, KB-
dc.contributor.authorGwon, HC-
dc.contributor.authorJeong, MH-
dc.contributor.authorJang, Y-
dc.contributor.authorKim, HS-
dc.contributor.authorSeong, IW-
dc.contributor.authorPark, HS-
dc.contributor.authorAhn, T-
dc.contributor.authorChae, IH-
dc.contributor.authorTahk, SJ-
dc.contributor.authorPark, SJ-
dc.description.abstractBACKGROUND: Comparative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) disease were previously reported. However, data on very long-term (>10 years) outcomes are limited.
OBJECTIVES: The authors compare 10-year outcomes after PCI and CABG for LMCA disease.
METHODS: In this observational study of the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty versus Surgical Revascularization) registry, the authors evaluated 2,240 patients with unprotected LMCA disease who underwent PCI (n = 1,102) or underwent CABG (n = 1,138) between January 2000 and June 2006. Adverse outcomes (death: a composite outcome of death, Q-wave myocardial infarction, or stroke: and target-vessel revascularization) were compared with the use of propensity scores and inverse-probability-weighting adjustment. The follow-up was extended to at least 10 years of all patients (median 12.0 years).
RESULTS: In the overall cohort, there was no significant difference in adjusted risks of death and the composite outcome between the groups up to 10 years. The risk of target-vessel revascularization was significantly higher in the PCI group. In the cohort comparing drug-eluting stents and concurrent CABG, the 2 study groups did not differ significantly in the risks of death and the composite outcome at 5 years. However, after 5 years, drug-eluting stents were associated with higher risks of death (hazard ratio: 1.35: 95% confidence interval: 1.00 to 1.81) and the composite outcome (hazard ratio: 1.46: 95% confidence interval: 1.10 to 1.94) compared with CABG.
CONCLUSIONS: In patients with significant LMCA disease, as compared with CABG, PCI showed similar rates of death and serious composite outcomes, but a higher rate of target-vessel revascularization at 10 years. However, CABG showed lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years. (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty versus Surgical Revascularization [MAIN-COMPARE]: NCT02791412).
dc.title10-Year Outcomes of Stents Versus Coronary Artery Bypass Grafting for Left Main Coronary Artery Disease-
dc.subject.keywordbypass surgery-
dc.subject.keywordcoronary artery disease-
dc.contributor.affiliatedAuthor탁, 승제-
dc.type.localJournal Papers-
dc.citation.titleJournal of the American College of Cardiology-
dc.citation.number23 Pt A-
dc.identifier.bibliographicCitationJournal of the American College of Cardiology, 72(23 Pt A). : 2813-2822, 2018-
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Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
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