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

74 Citations (Scopus)

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

Fingerprint

Drug-Eluting Stents
Coronary Artery Bypass
Coronary Artery Disease
Therapeutics
Coronary Stenosis
Mortality
Peripheral Vascular Diseases
Incidence
Acute Coronary Syndrome
Stroke Volume
Myocardial Infarction

Keywords

  • Bypass
  • Coronary disease
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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

In: European Heart Journal, Vol. 28, No. 22, 11.2007, p. 2714-2719.

Research output: Contribution to journalArticle

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, vol. 28, no. 22, pp. 2714-2719. https://doi.org/10.1093/eurheartj/ehm403
Palmerini, Tullio ; Barlocco, Fabio ; Santarelli, Andrea ; Bacchi-Reggiani, Letizia ; Savini, Carlo ; Baldini, Elisa ; Alessi, Laura ; Ruffini, Michele ; Di Credico, Germano ; Piovaccari, Giancarlo ; Di Bartolomeo, Roberto ; Marzocchi, Antonio ; Branzi, Angelo ; De Servi, Stefano. / 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). In: European Heart Journal. 2007 ; Vol. 28, No. 22. pp. 2714-2719.
@article{8dd9886c538b4dae8bb3039756044f48,
title = "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)",
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.",
keywords = "Bypass, Coronary disease, Stents",
author = "Tullio Palmerini and Fabio Barlocco and Andrea Santarelli and Letizia Bacchi-Reggiani and Carlo Savini and Elisa Baldini and Laura Alessi and Michele Ruffini and {Di Credico}, Germano and Giancarlo Piovaccari and {Di Bartolomeo}, Roberto and Antonio Marzocchi and Angelo Branzi and {De Servi}, Stefano",
year = "2007",
month = "11",
doi = "10.1093/eurheartj/ehm403",
language = "English",
volume = "28",
pages = "2714--2719",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "22",

}

TY - JOUR

T1 - 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)

AU - Palmerini, Tullio

AU - Barlocco, Fabio

AU - Santarelli, Andrea

AU - Bacchi-Reggiani, Letizia

AU - Savini, Carlo

AU - Baldini, Elisa

AU - Alessi, Laura

AU - Ruffini, Michele

AU - Di Credico, Germano

AU - Piovaccari, Giancarlo

AU - Di Bartolomeo, Roberto

AU - Marzocchi, Antonio

AU - Branzi, Angelo

AU - De Servi, Stefano

PY - 2007/11

Y1 - 2007/11

N2 - 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.

AB - 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.

KW - Bypass

KW - Coronary disease

KW - Stents

UR - http://www.scopus.com/inward/record.url?scp=36248984699&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36248984699&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehm403

DO - 10.1093/eurheartj/ehm403

M3 - Article

C2 - 17901080

AN - SCOPUS:36248984699

VL - 28

SP - 2714

EP - 2719

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 22

ER -