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 >=75 years)
2007; Oxford University Press; Volume: 28; Issue: 22 Linguagem: Inglês
10.1093/eurheartj/ehm403
ISSN1522-9645
AutoresTullio Palmerini, F. Barlocco, Andrea Santarelli, Maria Letizia Bacchi Reggiani, Claudia Savini, E Baldini, Luca Alessi, M. Ruffini, G. Di Credico, Giancarlo Piovaccari, Roberto Di Bartolomeo, A Marzocchi, Angelo Branzi, Stefano De Servi,
Tópico(s)Cardiac Imaging and Diagnostics
ResumoIn 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).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.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.
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