Abstract
BACKGROUND - Improvements in results with percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may extend their use in patients with left main coronary artery (LMCA) stenosis. METHODS AND RESULTS - Two hundred forty-nine patients with LMCA stenosis were treated with PCI and DES implantation (n=107) or coronary artery bypass grafting (CABG) (n=142), in a single center, between March 2002 and July 2004. A propensity analysis was performed to adjust for baseline differences between the two cohorts. At 1 year, there was no statistical difference in the occurrence of death in PCI versus CABG both for the unadjusted (OR=0.291; 95% CI=0.054 to 1.085; P=0.0710) and adjusted analyses (OR=0.331; 95% CI=0.055 to 1.404; P=0.1673). PCI was correlated to a lower occurrence of the composite end points of death and myocardial infarction (unadjusted OR=0.235; 95% CI=0.048 to 0.580; P=0.0002; adjusted OR=0.260; 95% CI=0.078 to 0.597; P=0.0005) and death, myocardial infarction, and cerebrovascular events (unadjusted OR=0.300; 95% CI=0.102 to 0.617; P=0.0004; adjusted OR=0.385; 95% CI=0.180 to 0.819; P=0.01). No difference was detected in the occurrence of major adverse cardiac and cerebrovascular event at the unadjusted (OR=0.675; 95% CI=0.371 to 1.189; P=0.1891) and adjusted analyses (OR=0.568; 95% CI=0.229 to 1.344; P=0.2266). CONCLUSIONS - At 1 year, in this single-center, retrospective experience, there was no difference in the degree of protection against death, stroke, myocardial infarction, and revascularization between PCI with DES and CABG for LMCA disease.
| Original language | English |
|---|---|
| Pages (from-to) | 2542-2547 |
| Number of pages | 6 |
| Journal | Circulation |
| Volume | 113 |
| Issue number | 21 |
| DOIs | |
| Publication status | Published - May 2006 |
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Keywords
- Drug-eluting stents
- Left main coronary artery stenosis
- Stents
- Surgery
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Percutaneous treatment with drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis : A single-center experience. / Chieffo, Alaide; Morici, Nuccia; Maisano, Francesco; Bonizzoni, Erminio; Cosgrave, John; Montorfano, Matteo; Airoldi, Flavio; Carlino, Mauro; Michev, Iassen; Melzi, Gloria; Sangiorgi, Giuseppe; Alfieri, Ottavio; Colombo, Antonio.
In: Circulation, Vol. 113, No. 21, 05.2006, p. 2542-2547.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Percutaneous treatment with drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis
T2 - A single-center experience
AU - Chieffo, Alaide
AU - Morici, Nuccia
AU - Maisano, Francesco
AU - Bonizzoni, Erminio
AU - Cosgrave, John
AU - Montorfano, Matteo
AU - Airoldi, Flavio
AU - Carlino, Mauro
AU - Michev, Iassen
AU - Melzi, Gloria
AU - Sangiorgi, Giuseppe
AU - Alfieri, Ottavio
AU - Colombo, Antonio
PY - 2006/5
Y1 - 2006/5
N2 - BACKGROUND - Improvements in results with percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may extend their use in patients with left main coronary artery (LMCA) stenosis. METHODS AND RESULTS - Two hundred forty-nine patients with LMCA stenosis were treated with PCI and DES implantation (n=107) or coronary artery bypass grafting (CABG) (n=142), in a single center, between March 2002 and July 2004. A propensity analysis was performed to adjust for baseline differences between the two cohorts. At 1 year, there was no statistical difference in the occurrence of death in PCI versus CABG both for the unadjusted (OR=0.291; 95% CI=0.054 to 1.085; P=0.0710) and adjusted analyses (OR=0.331; 95% CI=0.055 to 1.404; P=0.1673). PCI was correlated to a lower occurrence of the composite end points of death and myocardial infarction (unadjusted OR=0.235; 95% CI=0.048 to 0.580; P=0.0002; adjusted OR=0.260; 95% CI=0.078 to 0.597; P=0.0005) and death, myocardial infarction, and cerebrovascular events (unadjusted OR=0.300; 95% CI=0.102 to 0.617; P=0.0004; adjusted OR=0.385; 95% CI=0.180 to 0.819; P=0.01). No difference was detected in the occurrence of major adverse cardiac and cerebrovascular event at the unadjusted (OR=0.675; 95% CI=0.371 to 1.189; P=0.1891) and adjusted analyses (OR=0.568; 95% CI=0.229 to 1.344; P=0.2266). CONCLUSIONS - At 1 year, in this single-center, retrospective experience, there was no difference in the degree of protection against death, stroke, myocardial infarction, and revascularization between PCI with DES and CABG for LMCA disease.
AB - BACKGROUND - Improvements in results with percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may extend their use in patients with left main coronary artery (LMCA) stenosis. METHODS AND RESULTS - Two hundred forty-nine patients with LMCA stenosis were treated with PCI and DES implantation (n=107) or coronary artery bypass grafting (CABG) (n=142), in a single center, between March 2002 and July 2004. A propensity analysis was performed to adjust for baseline differences between the two cohorts. At 1 year, there was no statistical difference in the occurrence of death in PCI versus CABG both for the unadjusted (OR=0.291; 95% CI=0.054 to 1.085; P=0.0710) and adjusted analyses (OR=0.331; 95% CI=0.055 to 1.404; P=0.1673). PCI was correlated to a lower occurrence of the composite end points of death and myocardial infarction (unadjusted OR=0.235; 95% CI=0.048 to 0.580; P=0.0002; adjusted OR=0.260; 95% CI=0.078 to 0.597; P=0.0005) and death, myocardial infarction, and cerebrovascular events (unadjusted OR=0.300; 95% CI=0.102 to 0.617; P=0.0004; adjusted OR=0.385; 95% CI=0.180 to 0.819; P=0.01). No difference was detected in the occurrence of major adverse cardiac and cerebrovascular event at the unadjusted (OR=0.675; 95% CI=0.371 to 1.189; P=0.1891) and adjusted analyses (OR=0.568; 95% CI=0.229 to 1.344; P=0.2266). CONCLUSIONS - At 1 year, in this single-center, retrospective experience, there was no difference in the degree of protection against death, stroke, myocardial infarction, and revascularization between PCI with DES and CABG for LMCA disease.
KW - Drug-eluting stents
KW - Left main coronary artery stenosis
KW - Stents
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=32644444363&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=32644444363&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.105.595694
DO - 10.1161/CIRCULATIONAHA.105.595694
M3 - Article
C2 - 16717151
AN - SCOPUS:32644444363
VL - 113
SP - 2542
EP - 2547
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 21
ER -