Coronary artery bypass grafting versus stent implantation in patients with chronic coronary syndrome and left main disease: insights from a register throughout Germany

Autor: Klaus Kaier, Peter Stachon, Manfred Zehender, Dawid L. Staudacher, Andreas Zirlik, Christoph Bode, Dennis Wolf, Philip Hehn, Constantin von zur Mühlen, Vera Oettinger, Alexander Peikert, Daniel Duerschmied
Rok vydání: 2021
Předmět:
Zdroj: Clinical Research in Cardiology
ISSN: 1861-0692
1861-0684
DOI: 10.1007/s00392-021-01931-x
Popis: Background Recent randomized controlled trials have sparked debate about the optimal treatment of patients suffering from left main coronary artery disease. The present study analyzes outcomes of left main stenting versus coronary bypass grafting (CABG) in a nationwide registry in patients with chronic coronary syndrome (CCS). Methods All cases suffering from CCS and left main coronary artery disease treated either with CABG or stent, were identified within the database of the German bureau of statistics. Logistic or linear regression models were used with 20 baseline patient characteristics as potential confounders to compare both regimens. Results In 2018, 1318 cases with left main stenosis were treated with CABG and 8,920 with stent. Patients assigned for stenting were older (72.58 ± 9.87 vs. 68.63 ± 9.40, p p p = 0.748; aOR stroke: 0.59 [0.27; 1.32], p = 0.199). Stent implantation was associated with a reduced risk of relevant bleeding (aOR 0.38 [0.24; 0.61], p p = 0.002), and postoperative delirium (aOR 0.16 [0.11; 0.22], p p p Conclusion Left main stenting is a safe and effective treatment option for CCS-patients suffering from left main coronary artery disease at reasonable economic cost. Graphic abstract
Databáze: OpenAIRE
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