Long-term clinical outcomes after percutaneous coronary intervention versus coronary artery bypass grafting for acute coronary syndrome from the DELTA registry: A multicentre registry evaluating percutaneous coronary intervention versus coronary artery bypass grafting for left main treatment

Stylianos A. Pyxaras, Lukas Hunziker, Alaide Chieffo, Emanuele Meliga, Azeem Latib, 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, Roxana Mehran, Ronan Margey, Arvind Agnihotri, Sebastiano MarraDavide Capodanno, Martin B. Leon, Jeffrey W. Moses, Jean Fajadet, Thierry Lefevre, Marie Claude Morice, Andrejs Erglis, Corrado Tamburino, Ottavio Alfieri, Patrick W. Serruys, Antonio Colombo, Christoph Naber, Henning Kelbaek

Research output: Contribution to journalArticle

Abstract

Aims: Our aim was to compare, in a large unprotected left main coronary artery (ULMCA) all-comer registry, the long-term clinical outcome after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS). Methods and results: Of a total of 2,775 patients enrolled in the Drug Eluting Stents for Left Main Coronary Artery Disease (DELTA) multicentre registry, 379 (13.7%) patients with ACS treated with PCI (n=272) or CABG (n=107) were analysed. Baseline demographics were considerably different in the two groups before propensity matching. No significant differences emerged for the composite endpoint of all-cause death, myocardial infarction (MI), and cerebrovascular accident (HR 1.11, 95% CI: 0.63-1.94; p=0.727), all-cause death (HR 1.26, 95% CI: 0.68-2.32; p=0.462), the composite endpoint of all-cause death and MI (HR 1.02, 95% CI: 0.56-1.84; p=0.956), and major adverse cardiac and cerebrovascular events (HR 0.82, 95% CI: 0.50-1.36; p=0.821). However, a higher incidence of target vessel revascularisation (HR 4.67, 95% CI: 1.33-16.47; p=0.008) was observed in the PCI compared with the CABG group, which was confirmed in the propensity score-matched analysis. Conclusions: In the DELTA all-comer, multinational registry, PCI for ACS in ULMCA is associated with comparable clinical outcomes to those observed with CABG at long-term follow-up, despite the use of firstgenerationDES.

Original languageEnglish
Pages (from-to)e623-e631
JournalEuroIntervention
Volume12
Issue number5
DOIs
Publication statusPublished - Aug 1 2016

Keywords

  • Acute coronary syndrome
  • Bypass grafting(cabg)
  • Coronary artery
  • Outcome
  • Percutaneous coronary intervention (pci)
  • Unprotected left main

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Pyxaras, S. A., Hunziker, L., Chieffo, A., Meliga, E., Latib, A., 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., Mehran, R., Margey, R., Agnihotri, A., ... Kelbaek, H. (2016). Long-term clinical outcomes after percutaneous coronary intervention versus coronary artery bypass grafting for acute coronary syndrome from the DELTA registry: A multicentre registry evaluating percutaneous coronary intervention versus coronary artery bypass grafting for left main treatment. EuroIntervention, 12(5), e623-e631. https://doi.org/10.4244/EIJV12I5A102