Comparison of percutaneous coronary intervention (with drug-eluting stents) versus coronary artery bypass grafting in women with severe narrowing of the left main coronary artery (from the women-drug-eluting stent for left main coronary artery disease registry)

Gill Louise Buchanan, Alaide Chieffo, Emanuele Meliga, Roxana Mehran, Seung Jung Park, Yoshinobu Onuma, Piera Capranzano, Marco Valgimigli, Inga Narbute, Raj R. Makkar, Igor F. Palacios, Young Hak Kim, Piotr P. Buszman, Tarun Chakravarty, Imad Sheiban, Christoph Naber, Ronan Margey, Arvind Agnihotri, Sebastiano Marra, Davide CapodannoVictoria Allgar, Martin B. Leon, Jeffrey W. Moses, Jean Fajadet, Thierry Lefevre, Marie Claude Morice, Andrejs Erglis, Corrado Tamburino, Ottavio Alfieri, Patrick W. Serruys, Antonio Colombo

Research output: Contribution to journalArticle

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

Original languageEnglish
Pages (from-to)1348-1355
Number of pages8
JournalThe American Journal of Cardiology
Volume113
Issue number8
DOIs
Publication statusPublished - Apr 15 2014

    Fingerprint

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Buchanan, G. L., Chieffo, A., Meliga, E., Mehran, R., Park, S. J., Onuma, Y., Capranzano, P., Valgimigli, M., Narbute, I., Makkar, R. R., Palacios, I. F., Kim, Y. H., Buszman, P. P., Chakravarty, T., Sheiban, I., Naber, C., Margey, R., Agnihotri, A., Marra, S., ... Colombo, A. (2014). Comparison of percutaneous coronary intervention (with drug-eluting stents) versus coronary artery bypass grafting in women with severe narrowing of the left main coronary artery (from the women-drug-eluting stent for left main coronary artery disease registry). The American Journal of Cardiology, 113(8), 1348-1355. https://doi.org/10.1016/j.amjcard.2014.01.409