Revascularization for Isolated Proximal Left Anterior Descending Artery Disease
| Autor: | Ye Zhong, Jeffrey P. Gold, Joanna Chikwe, Desmond Jordan, Leonard N. Girardi, Andrew S. Wechsler, Kimberly Cozzens, David H. Adams, Craig R. Smith, Stephen J. Lahey, Thoralf M. Sundt, Edward L. Hannan |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors medicine.medical_treatment Coronary Artery Disease Coronary Angiography Revascularization Coronary artery disease Percutaneous Coronary Intervention Risk Factors Internal medicine Humans Medicine Registries cardiovascular diseases Myocardial infarction Coronary Artery Bypass Stroke Aged Retrospective Studies business.industry Hazard ratio Percutaneous coronary intervention Drug-Eluting Stents Middle Aged medicine.disease Coronary Vessels Treatment Outcome surgical procedures operative Drug-eluting stent Conventional PCI Cardiology Female Surgery Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 112:555-562 |
| ISSN: | 0003-4975 |
| Popis: | Background Most studies of patients with isolated proximal left anterior descending (PLAD) coronary artery disease do not include all 3 procedural options: percutaneous coronary intervention (PCI), conventional coronary artery bypass graft (CABG) surgery, or minimally invasive CABG. Methods New York’s cardiac registries were used to identify patients who underwent revascularization for isolated PLAD disease between January 1, 2010, and November 30, 2016, in New York State. After exclusions, 14,327 patients, of whom 13,115 received PCI, 1001 of whom underwent CABG surgery, and 211 of whom underwent minimally invasive CABG were monitored through the end of 2017 to compare outcomes. Registry data were matched to vital statistics data to obtain deaths occurring after discharge and matched to claims data to obtain subsequent admissions for myocardial infarction and stroke. Results There were no significant differences in mortality or in mortality/myocardial infarction/stroke after 7 years (with median follow-up times in excess of 4 years) among the 3 procedures after adjusting for differences in patient risk factors. However, conventional CABG surgery was associated with a lower subsequent revascularization rate than PCI (adjusted hazard ratio, 0.45; 95% confidence interval, 0.35-0.58) and minimally invasive CABG surgery (adjusted hazard ratio, 0.46; 95% confidence interval, 0.32-0.66). Conclusions Among patients with isolated PLAD disease undergoing any of 3 revascularization options (PCI, conventional CABG surgery, or minimally invasive CABG surgery), conventional CABG surgery was associated with lower subsequent revascularization rates, but there were no differences in mortality or mortality/myocardial infarction/stroke rates. |
| Databáze: | OpenAIRE |
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