A comparison between coronary artery bypass grafting surgery and drug eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged ≥75 years)

Tullio Palmerini, Fabio Barlocco, Andrea Santarelli, Letizia Bacchi-Reggiani, Carlo Savini, Elisa Baldini, Laura Alessi, Michele Ruffini, Germano Di Credico, Giancarlo Piovaccari, Roberto Di Bartolomeo, Antonio Marzocchi, Angelo Branzi, Stefano De Servi

Research output: Contribution to journalArticle

Abstract

Aims: In this study, we compared the clinical outcomes of elderly patients with unprotected left main coronary artery (ULMCA) stenosis treated with either coronary artery bypass grafting (CABG) or drug-eluting stent (DES). Methods and results: From January 2003 to April 2006, 259 patients with ULMCA stenosis and age ≥75 years underwent coronary revascularization with either CABG or DES. One hundred and sixty-one patients were treated with CABG and 98 with DES. The cumulative unadjusted rates of 2-year mortality were 17% in CABG-treated patients and 18% in those treated with DES (P = 0.71). The adjusted rates of 2-year survival were 85% for CABG-treated patients and 87% for DES-treated patients (P = 0.74). The incidence of 2-year myocardial infarction was 6% in CABG-treated patients and 4% in DES-treated patients (P = 0.11). The incidence of target lesion revascularization (TLR) was 3% in CABG-treated patients and 25% in DES-treated patients (P <0.0001). In the multivariable analysis, peripheral vascular disease, left ventricular ejection fraction and acute coronary syndrome were independent predictors of 2-year mortality. Conclusion: In this study, we could not demonstrate a difference in mortality between CABG-treated patients and those treated with DES. However, the rate of TLR was higher in the DES group.

Original languageEnglish
Pages (from-to)2714-2719
Number of pages6
JournalEuropean Heart Journal
Volume28
Issue number22
DOIs
Publication statusPublished - Nov 2007

Keywords

  • Bypass
  • Coronary disease
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Palmerini, T., Barlocco, F., Santarelli, A., Bacchi-Reggiani, L., Savini, C., Baldini, E., Alessi, L., Ruffini, M., Di Credico, G., Piovaccari, G., Di Bartolomeo, R., Marzocchi, A., Branzi, A., & De Servi, S. (2007). A comparison between coronary artery bypass grafting surgery and drug eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged ≥75 years). European Heart Journal, 28(22), 2714-2719. https://doi.org/10.1093/eurheartj/ehm403