Long-term outcome comparison of ostial/shaft lesions in unprotected left main coronary artery treated by PCI or CABG.
10.3760/cma.j.cn112148-20191226-00769
- VernacularTitle:PCI和CABG治疗无保护左主干开口/体部病变的远期预后比较
- Author:
Xian Peng YU
1
;
Ze Ning JIN
1
;
Yu LI
1
;
Chang Yan WU
1
;
Ji Qiang HE
1
;
Ya Wei LUO
1
;
Li Zhong SUN
1
;
Ran DONG
1
Author Information
1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass grafting;
Coronary artery disease;
Left main ostium /shaft;
Percutaneous coronary intervention;
Prognosi.
- MeSH:
Aged;
Coronary Artery Bypass;
Coronary Artery Disease/surgery*;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Percutaneous Coronary Intervention;
Risk Factors;
Stroke Volume;
Treatment Outcome;
Ventricular Function, Left
- From:
Chinese Journal of Cardiology
2020;48(6):484-488
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention(PCI) with drug-eluting stents(DES) for ostial/shaft lesions in unprotected left main coronary artery(ULMCA). Method: A total of 259 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery were enrolled consecutively who received DES implantation or underwent CABG between January 2003 and July 2009 in Beijing Anzhen Hospital. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI) and stroke. Time to the primary endpoint was evaluated according to the Kaplan-Meier method, and the log-rank test was applied to compare the incidence of the endpoint. Adjusted risks for adverse outcomes were compared by multivariate Cox proportional hazard regression analyses. Results: A total of 259 patients were included, including 149 in PCI group and 110 in CABG group. And 193(74.5%) cases were males.The age was (61.4±9.8) years old. The median follow-up was 10.1 years (interquartile range 8.3 to 11.2 years) in the overall patients. There were no significant difference for the incidence of death [37.0% vs. 43.1% ，P=0.143] , MI [34.0% vs. 19.4% ，P=0.866], stroke [6.4% vs. 11.7% ， P=0.732], repeart revascularization [33.6% vs. 39.9% ，P=0.522] between PCI group and CABG group before multivariate adjusting，according to the incidence calculated with Kaplan-Meier. After adjusting covariates such as age, left ventricular ejection fraction（LVEF） and serum creatine with multivariate Cox hazard regression model, there was still no significant difference between the two groups. Conclusions: PCI with DES is as effective and safe as CABG in patients with left main ostium/shaft lesion during a median follow-up of 10.1 years.
