28 297

Cited 367 times in

Stents versus coronary-artery bypass grafting for left main coronary artery disease.

Authors
Seung, KB; Park, DW; Kim, YH; Lee, SW; Lee, CW; Hong, MK; Park, SW; Yun, SC; Gwon, HC; Jeong, MH; Jang, Y; Kim, HS; Kim, PJ; Seong, IW; Park, HS; Ahn, T; Chae, IH; Tahk, SJ; Chung, WS; Park, SJ
Citation
The New England journal of medicine, 358(17):1781-1792, 2008
Journal Title
The New England journal of medicine
ISSN
0028-47931533-4406
Abstract
BACKGROUND: Several studies have compared the treatment effects of coronary stenting and coronary-artery bypass grafting (CABG). However, there are limited data regarding the long-term outcomes of these two interventions for patients with unprotected left main coronary artery disease. METHODS: We evaluated 1102 patients with unprotected left main coronary artery disease who underwent stent implantation and 1138 patients who underwent CABG in Korea between January 2000 and June 2006. We compared adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction, or stroke; and target-vessel revascularization) with the use of propensity-score matching in the overall cohort and in separate subgroups according to type of stent. RESULTS: In the overall matched cohort, there was no significant difference between the stenting and CABG groups in the risk of death (hazard ratio for the stenting group, 1.18; 95% confidence interval [CI], 0.77 to 1.80) or the risk of the composite outcome (hazard ratio for the stenting group, 1.10; 95% CI, 0.75 to 1.62). The rates of target-vessel revascularization were significantly higher in the group that received stents than in the group that underwent CABG (hazard ratio, 4.76; 95% CI, 2.80 to 8.11). Comparisons of the group that received bare-metal stents with the group that underwent CABG and of the group that received drug-eluting stents with the group that underwent CABG produced similar results, although there was a trend toward higher rates of death and the composite end point in the group that received drug-eluting stents. CONCLUSIONS: In a cohort of patients with unprotected left main coronary artery disease, we found no significant difference in rates of death or of the composite end point of death, Q-wave myocardial infarction, or stroke between patients receiving stents and those undergoing CABG. However, stenting, even with drug-eluting stents, was associated with higher rates of target-vessel revascularization than was CABG. Copyright © 2008 Massachusetts Medical Society.
MeSH terms
AgedAngioplasty, Balloon, Coronary*Cohort StudiesCoronary Artery Bypass*Coronary Disease/mortalityCoronary Disease/surgeryCoronary Disease/therapy*Drug-Eluting StentsFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial Infarction/epidemiologyMyocardial RevascularizationRisk FactorsStents*Stroke/epidemiologyTreatment Outcome
DOI
10.1056/NEJMoa0801441
PMID
18378517
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
탁승제
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse