Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiovascular Intervention
Percutaneous Treatment With Drug-Eluting Stent vs Bypass Surgery in Patients Suffering From Chronic Stable Angina With Multivessel Disease Involving Significant Proximal Stenosis in Left Anterior Descending Artery
Qiao Yan, Ma Changsheng, Nie Shaoping, Liu Xiaohui, Kang Junping, Lv Qiang, Du Xin, Hu Rong, Zhang Yin, Jia Changqi, Wu Jiahui, Liu Xinmin, Dong Jianzeng, Chen Fang, Zhou Yujie, Lv Shuzheng, Huang Fangjiong, Gu Chengxiong, Wu Xuesi
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Keywords: Coronary artery bypass grafting, Coronary artery disease, Drug-eluting stent, Percutaneous coronary intervention
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2009 Volume 73 Issue 10 Pages 1848-1855

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Abstract

Background: The aim of the present study was to compare the effects of drug-eluting stents (DES) and coronary artery bypass grafting (CABG) in patients suffering from chronic stable angina with multivessel disease, involving significant proximal stenosis in the left anterior descending artery (LAD). Methods and Results: All consecutive patients suffering from chronic stable angina with multivessel disease involving significant proximal LAD stenosis underwent DES implantation (n=600) or CABG (n=709) at our institution. At 2 years, the unadjusted mortality was significantly lower in the DES group than in the CABG group (2.2% vs 5.2%, P=0.004), but the adjusted risk of death was similar (odds ratio (OR) 0.74, 95%CI 0.28-1.97, P=0.555). Furthermore, both the adjusted rate of nonfatal myocardial infarction and cerebrovascular events was also comparable. However, the unadjusted and adjusted risk of major adverse cardiac cerebrovascular events in the DES was significantly higher than in the CABG (13.3% vs 9.6%, OR 2.71, 95%CI 1.56-4.74, P<0.001), which is probably attributed to the higher subsequent revascularization rate after DES implantation. Conclusions: DES showed comparable long-term mortality for the treatment of multivessel disease involving significant proximal stenosis in LAD in comparison with CABG. (Circ J 2009; 73: 1848-1855)

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© 2009 THE JAPANESE CIRCULATION SOCIETY
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