A comparison between coronary artery bypass grafting surgery and drug eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged > or =75 years).

Abstract:

AIMS:In this study, we compared the clinical outcomes of elderly patients with unprotected left main coronary artery (ULMCA) stenosis treated with either coronary artery bypass grafting (CABG) or drug-eluting stent (DES). METHODS AND RESULTS:From January 2003 to April 2006, 259 patients with ULMCA stenosis and age > or =75 years underwent coronary revascularization with either CABG or DES. One hundred and sixty-one patients were treated with CABG and 98 with DES. The cumulative unadjusted rates of 2-year mortality were 17% in CABG-treated patients and 18% in those treated with DES (P = 0.71). The adjusted rates of 2-year survival were 85% for CABG-treated patients and 87% for DES-treated patients (P = 0.74). The incidence of 2-year myocardial infarction was 6% in CABG-treated patients and 4% in DES-treated patients (P = 0.11). The incidence of target lesion revascularization (TLR) was 3% in CABG-treated patients and 25% in DES-treated patients (P < 0.0001). In the multivariable analysis, peripheral vascular disease, left ventricular ejection fraction and acute coronary syndrome were independent predictors of 2-year mortality. CONCLUSION:In this study, we could not demonstrate a difference in mortality between CABG-treated patients and those treated with DES. However, the rate of TLR was higher in the DES group.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Palmerini T,Barlocco F,Santarelli A,Bacchi-Reggiani L,Savini C,Baldini E,Alessi L,Ruffini M,Di Credico G,Piovaccari G,Di Bartolomeo R,Marzocchi A,Branzi A,De Servi S

doi

10.1093/eurheartj/ehm403

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

2714-9

issue

22

eissn

0195-668X

issn

1522-9645

pii

ehm403

journal_volume

28

pub_type

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