Details

Autor(en) / Beteiligte

• Chang, Mineok, MD
• Lee, Cheol Whan, MD
• Ahn, Jung-Min, MD
• Cavalcante, Rafael, MD
• Sotomi, Yohei, MD
• Onuma, Yoshinobu, MD
• Han, Minkyu, PhD
• Park, Duk-Woo, MD
• Kang, Soo-Jin, MD
• Lee, Seung-Whan, MD
• Kim, Young-Hak, MD
• Park, Seong-Wook, MD, PhD
• Serruys, Patrick W., MD, PhD
• Park, Seung-Jung, MD, PhD

Titel

Comparison of Outcome of Coronary Artery Bypass Grafting versus Drug-Eluting Stent Implantation for Non-ST-Elevation Acute Coronary Syndrome

Ist Teil von

• The American journal of cardiology, 2017-08, Vol.120 (3), p.380-386

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract There is limited data comparing effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). We compared the long-term outcomes of the two revascularization strategies in 1,246 patients presented with NSTE-ACS for left main or multivessel coronary artery disease (CAD). Data were pooled from the BEST, PRECOMBAT, and SYNTAX trials. The primary outcome was a composite of death from any causes, myocardial infarction, or stroke. The baseline characteristics were similar between the two study groups. During the median follow-up of 60 months, the rate of the primary outcome was significantly lower with CABG than with PCI (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.56−0.98; P=0.036). This difference was mainly attributed to a significant reduction in the rate of myocardial infarction (HR: 0.50; 95% CI: 0.31−0.82, P=0.006). The superiority of CABG over PCI was consistent across the major subgroups. The individual risks of death from any causes or stroke were not different between the two groups. In contrast, the rate of repeat revascularization was significantly lower in the CABG group than in the PCI group (HR: 0.56; 95% CI: 0.41−0.75, P < 0.001). In this study, among patients with NSTE-ACS for left main or multivessel CAD, CABG significantly reduces the risk of death from any causes, myocardial infarction, or stroke compared to PCI with DES.