Author/Authors :
Buchanan، نويسنده , , Gill Louise and Chieffo، نويسنده , , Alaide and Meliga، نويسنده , , Emanuele and Mehran، نويسنده , , Roxana and Park، نويسنده , , Seung-Jung and Onuma، نويسنده , , Yoshinobu and Capranzano، نويسنده , , Piera and Valgimigli، نويسنده , , Marco and Narbute، نويسنده , , Inga and Makkar، نويسنده , , Raj R. and Palacios، نويسنده , , Igor F. and Kim، نويسنده , , Young-Hak and Buszman، نويسنده , , Piotr P. and Chakravarty، نويسنده , , Tarun and Sheiban، نويسنده , , Imad and Naber، نويسنده , , Christoph and Margey، نويسنده , , Ronan and Agnihotri، نويسنده , , Arvind and Marra، نويسنده , , Sebastiano and Capodanno، نويسنده , , Davide and Allgar، نويسنده , , Victoria and Leon، نويسنده , , Martin B. and Moses، نويسنده , , Jeffrey W. and Fajadet، نويسنده , , Jean-Françis Lefèvre، نويسنده , , Thierry and Morice، نويسنده , , Marie-Claude and Erglis، نويسنده , , Andrejs and Tamburino، نويسنده , , Corrado and Alfieri، نويسنده , , Ottavio and Serruys، نويسنده , , Patrick W. and Colombo، نويسنده , , Antonio، نويسنده ,
Abstract :
Women typically present with coronary artery disease later than men with more unfavorable clinical and anatomic characteristics. It is unknown whether differences exist in women undergoing treatment for unprotected left main coronary artery (ULMCA) disease. Our aim was to evaluate long-term clinical outcomes in women treated with percutaneous coronary intervention (PCI) with drug-eluting stents versus coronary artery bypass grafting (CABG). All consecutive women from the Drug-Eluting stent for LefT main coronary Artery disease registry with ULMCA disease were analyzed. A propensity matching was performed to adjust for baseline differences. In total, 817 women were included: 489 (59.8%) underwent treatment with PCI with drug-eluting stents versus 328 (40.2%) with CABG. Propensity score matching identified 175 matched pairs, and at long-term follow-up there were no differences in all-cause (odds ratio [OR] 0.722, 95% confidence interval [CI] 0.357 to 1.461, p = 0.365) or cardiovascular (OR 1.100, 95% CI 0.455 to 2.660, p = 0.832) mortality, myocardial infarction (MI; OR 0.362, 95% CI 0.094 to 1.388, p = 0.138), or cerebrovascular accident (CVA; OR 1.200, 95% CI 0.359 to 4.007, p = 0.767) resulting in no difference in the primary study objective of death, MI, or CVA (OR 0.711, 95% CI 0.387 to 1.308, p = 0.273). However, there was an advantage of CABG in major adverse cardiovascular and cerebrovascular events (OR 0.429, 95% CI 0.254 to 0.723, p = 0.001), driven exclusively by target vessel revascularization (OR 0.185, 95% CI 0.079 to 0.432, p <0.001). In women with significant ULMCA disease, no difference was observed after PCI or CABG in death, MI, and CVA at long-term follow-up.
