Author/Authors :
Park، نويسنده , , Duk-Woo and Seung، نويسنده , , Ki Bae and Kim، نويسنده , , Young-Hak and Lee، نويسنده , , Jong-Young and Kim، نويسنده , , Won-Jang and Kang، نويسنده , , Soo-Jin and Lee، نويسنده , , Seungwhan and Lee، نويسنده , , Cheol Whan and Park، نويسنده , , Seong-Wook and Yun، نويسنده , , Sung-Cheol and Gwon، نويسنده , , Hyeon-Cheol and Jeong، نويسنده , , Myung-Ho and Jang، نويسنده , , Yang Soo and Kim، نويسنده , , Hyosoo and Kim، نويسنده , , Pum Joon and Seong، نويسنده , , In-Whan and Park، نويسنده , , Hun Sik and Ahn، نويسنده , , Taehoon and Chae، نويسنده , , Byung-Ho and Tahk، نويسنده , , Seung-Jea and Chung، نويسنده , , Wook-Sung and Park، نويسنده , , Seung-Jung، نويسنده ,
Abstract :
Objectives
formed the long-term follow-up of a large cohort of patients in a multicenter study receiving left main coronary artery (LMCA) revascularization.
ound
d information is available on long-term outcomes for patients with unprotected LMCA disease who underwent coronary stent procedure or coronary artery bypass grafting (CABG).
s
luated 2,240 patients with unprotected LMCA disease who received coronary stents (n = 1,102; 318 with bare-metal stents and 784 with drug-eluting stents) or underwent CABG (n = 1,138) between 2000 and 2006 and for whom complete follow-up data were available for at least 3 to 9 years (median 5.2 years). The 5-year adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]) were compared with the use of the inverse probability of treatment weighted method and propensity-score matching.
s
adjustment for differences in baseline risk factors with the inverse probability of treatment weighting, the 5-year risk of death (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 0.88 to 1.44, p = 0.35) and the combined risk of death, Q-wave MI, or stroke (HR: 1.07; 95% CI: 0.84 to 1.37, p = 0.59) were not significantly different for patients undergoing stenting versus CABG. The risk of TVR was significantly higher in the stenting group than in the CABG group (HR: 5.11; 95% CI: 3.52 to 7.42, p < 0.001). Similar results were obtained in comparisons of bare-metal stent with concurrent CABG and of drug-eluting stent with concurrent CABG. In further analysis with propensity-score matching, overall findings were consistent.
sions
5-year follow-up, stenting showed similar rates of mortality and of the composite of death, Q-wave MI, or stroke but higher rates of TVR as compared with CABG for patients with unprotected LMCA disease.
