Left main coronary artery disease: percutaneous coronary intervention or coronary artery bypass grafting? A critical review of current knowledge and contemporary debates.

Autor:	Panagiotopoulos I; Department of Cardiothoracic Surgery, General University Hospital of Patras, Patras, Greece., Mulita F; Department of Surgery, General University Hospital of Patras, Patras, Greece., Verras GI; Department of Surgery, General University Hospital of Patras, Patras, Greece., Bekou E; Medical Physics Department, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece., Mulita A; Medical Physics Department, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece., Dahm M; Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany., Grapatsas K; Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen Essen, Germany., Sawafta A; Department of Cardiology, University Hospital of Larissa, Larissa, Greece., Katinioti A; Cardiology Department, Elpis General Hospital, Athens, Greece., Liolis E; Department of Oncology, General University Hospital of Patras, Patras, Greece., Pitros C; Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece., Tchabashvili L; Department of Surgery, General University Hospital of Patras, Patras, Greece., Tasios K; Department of Surgery, General University Hospital of Patras, Patras, Greece., Antzoulas A; Department of Surgery, General University Hospital of Patras, Patras, Greece., Papadoulas S; Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece., Koletsis E; Department of Cardiothoracic Surgery, General University Hospital of Patras, Patras, Greece., Leivaditis V; Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany.
Jazyk:	angličtina
Zdroj:	Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery [Kardiochir Torakochirurgia Pol] 2024 Jun; Vol. 21 (2), pp. 108-112. Date of Electronic Publication: 2024 Jun 30.
DOI:	10.5114/kitp.2024.141149
Abstrakt:	Significant unprotected left main (ULM) disease is the highest-risk coronary artery lesion, carries high morbidity and mortality related to a large amount of myocardium supplied, and should undergo prompt revascularization. Among recent randomized controlled trials (RCTs), NOBLE failed to demonstrate non-inferiority of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). However, all the other RCTs have shown comparable outcomes. While CABG is associated with higher stroke rates at 30 days and 1 year, PCI is associated with increased spontaneous myocardial infarction (MI) events and the need for repeat revascularization. Furthermore, the benefit of CABG is more evident with the increased complexity of coronary artery disease. In current European and American guidelines, CABG is the standard of care for ULM disease. PCI is considered a reasonable alternative in selected patients (2a B-NR). There is still a great need for carefully designed RCTs with longer follow-up times to validate the role of recent technological and pharmacological regimens. Competing Interests: The authors report no conflict of interest. (Copyright: © 2024 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF