Abstract | OBJECTIVES: BACKGROUND: The relative efficacy and safety of CABG versus PCI with DES for left main or multivessel CAD remain controversial. METHODS: RESULTS: The median follow-up was 60 months, and follow-up was completed for 96.2% of patients. The rate of primary outcome was significantly lower with CABG than with PCI (13.0% vs. 16.0%; hazard ratio [HR]: 0.83; 95% confidence interval [CI]: 0.69 to 1.00; p = 0.046). The difference was mainly driven by reduction in myocardial infarction (HR: 0.46; 95% CI: 0.33 to 0.64; p < 0.001). There was significant interaction between treatment effect and types of CAD, showing CABG to be superior compared with PCI with DES in patients with multivessel CAD (p = 0.001), but no between-group difference in those with left main CAD (p = 0.427). The rates for all-cause death and stroke were similar between the 2 groups. By contrast, the need for repeat revascularization was significantly lower in the CABG group compared with the PCI group. CONCLUSIONS: CABG, as compared with PCI with DES, reduced long-term rates of the composite of all-cause death, myocardial infarction, or stroke in patients with left main or multivessel CAD. The advantage of CABG over PCI with DES was particularly pronounced in those with multivessel CAD.
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Authors | Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Pannipa Suwannasom, Erhan Tenekecioglu, Sung-Cheol Yun, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park |
Journal | JACC. Cardiovascular interventions
(JACC Cardiovasc Interv)
Vol. 9
Issue 24
Pg. 2481-2489
(12 26 2016)
ISSN: 1876-7605 [Electronic] United States |
PMID | 28007199
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aged
- Coronary Artery Bypass
(adverse effects, mortality)
- Coronary Artery Disease
(diagnostic imaging, mortality, surgery, therapy)
- Drug-Eluting Stents
- Female
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Myocardial Infarction
(etiology)
- Percutaneous Coronary Intervention
(adverse effects, instrumentation, mortality)
- Proportional Hazards Models
- Prosthesis Design
- Randomized Controlled Trials as Topic
- Risk Factors
- Stroke
(etiology)
- Time Factors
- Treatment Outcome
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