Coronary artery diseaseComparison of Long-Term Outcome After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Unprotected Left Main Coronary Artery Disease (from the CREDO-Kyoto PCI/CABG Registry Cohort-2)
Section snippets
Methods
The Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) PCI/CABG Registry Cohort-2 is a physician-initiated, noncompany-sponsored, multicenter registry that enrolled consecutive patients undergoing first coronary revascularization in 26 centers in Japan from January 2005 through December 2007. The relevant ethics committees in all 26 participating centers (Supplementary Appendix A) approved the research protocol. Because of retrospective enrollment, written informed
Results
Patients in the PCI group were older and more often had malignancy and severe mitral regurgitation, whereas patients in the CABG group more often had diabetes on insulin therapy and thrombocytopenia (Table 1).
The CABG group included more patients with complex coronary anatomy and larger numbers of target lesions or anastomoses (Table 1). SYNTAX scores were available in 932 patients (92.7%). Median SYNTAX score was significantly higher in the CABG group than in the PCI group. Stents were used in
Discussion
The main findings in the present study were as follows. (1) Three-year clinical outcome of PCI was comparable to CABG for serious cardiovascular events in patients with ULMCAD. (2) Risk for serious cardiovascular events was not significantly different between PCI and CABG in patients with a low or intermediate SYNTAX score but was markedly higher after PCI compared to CABG in patients with a high SYNTAX score.
The favorable outcome of PCI for the treatment of ULMCAD as demonstrated in the ULMCAD
Acknowledgment
We appreciate the support and collaboration of the coinvestigators participating in the CREDO-Kyoto PCI/CABG Registry Cohort-2. We are indebted to the outstanding effort of the clinical research coordinators for data collection.
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Meta-Analysis of Prospective Studies of Risk stratification by Syntax Score for Unprotected Left Main Coronary Artery Revascularization
2021, American Journal of CardiologyPercutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Unprotected Left Main Coronary Artery Stenosis
2019, American Journal of the Medical SciencesCitation Excerpt :The study selection process is illustrated in Supplementary Figure 1. After applying the inclusion and exclusion criteria, 19 reports were selected for the meta-analysis, including 6 randomized12,13,20,22,25,26 and 13 prospective cohort studies.27-40 The characteristics of each study are described in Tables 1-2.
This study was supported by the Pharmaceuticals and Medical Devices Agency, Tokyo, Japan.