Title of article :
Randomized Comparison of Minimally Invasive Direct Coronary Artery Bypass Surgery Versus Sirolimus-Eluting Stenting in Isolated Proximal Left Anterior Descending Coronary Artery Stenosis
Author/Authors :
Thiele، نويسنده , , Holger and Neumann-Schniedewind، نويسنده , , Patrick H. Jacobs، نويسنده , , Stephan and Boudriot، نويسنده , , Enno and Walther، نويسنده , , Thomas and Mohr، نويسنده , , Friedrich-Wilhelm and Schuler، نويسنده , , Gerhard and Falk، نويسنده , , Volkmar، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2009
Pages :
8
From page :
2324
To page :
2331
Abstract :
Objectives rpose of this randomized study was to compare sirolimus-eluting stenting (SES) with minimally invasive direct coronary artery bypass (MIDCAB) surgery for patients with isolated proximal left anterior descending (LAD) coronary artery disease. ound etal stenting is inferior to MIDCAB surgery in patients with isolated proximal LAD lesions due to a higher reintervention rate with similar results for mortality and reinfarction. SES are effective in restenosis reduction. s l of 130 patients with significant proximal LAD coronary artery disease were randomized to either SES (n = 65) or MIDCAB surgery (n = 65). The primary clinical end point was noninferiority in freedom from major adverse cardiac events (MACE), such as cardiac death, myocardial infarction, and the need for target vessel revascularization within 12 months. s -up was completed for all patients. MACE occurred in 7.7% of patients after stenting, as compared with 7.7% after surgery (p = 0.03 for noninferiority). The individual components of the combined end point revealed mixed results. Although noninferiority was revealed for the difference in death and myocardial infarction (1.5% vs. 7.7%, noninferiority p < 0.001), noninferiority was not established for the difference in target vessel revascularization (6.2% vs. 0%, noninferiority p = 0.21). Clinical symptoms improved significantly in both treatment groups in comparison with baseline, and the percentage of patients free from angina after 12 months was 81% versus 74% (p = 0.49). sions lated proximal LAD disease, SES is noninferior to MIDCAB surgery at 12-month follow-up with respect to MACE at a similar relief in clinical symptoms. (MIDCAB Versus DES in Proximal LAD Lesions; NCT00299429)
Keywords :
Bypass , Coronary Artery Disease , restenosis , atherosclerosis , drug-eluting stents
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
2009
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
1744735
Link To Document :
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