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논문번호 74
논문제목(영문) Stents versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery Disease.
국내외구분 국외 SCI여부 SCI(E)
연구책임자역할 공저자
주저자명 Seung KB, Park DW
교신저자명 Park SJ
공동저자명 Seung KB, Park DW, Yun SC, Lee SW, Kim YH, Lee CW, Hong MK, Park SW, Gwon HC, Jeong MH, Jang YS, Kim HS, Kim PJ, Seong IW, Park HS, Ahn TH,Chae IH, Tahk SJ, Chung WS, Park SJ;
게제년월일 2008-04-24
ISSN 0028-4793
Impact Factor 55.873
학술지명 The New England journal of medicine
서지사항 0집 / 358권 / 17호,   페이지(1781 - 1792)
요약초록문
(Abstract) 입력		 BACKGROUND:
Several studies have compared the treatment effects of coronary stenting and coronary-artery bypass grafting (CABG). However, there are limited data regarding the long-term outcomes of these two interventions for patients with unprotected left main coronary artery disease.
METHODS:
We evaluated 1102 patients with unprotected left main coronary artery disease who underwent stent implantation and 1138 patients who underwent CABG in Korea between January 2000 and June 2006. We compared adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction, or stroke; and target-vessel revascularization) with the use of propensity-score matching in the overall cohort and in separate subgroups according to type of stent.
RESULTS:
In the overall matched cohort, there was no significant difference between the stenting and CABG groups in the risk of death (hazard ratio for the stenting group, 1.18; 95% confidence interval [CI], 0.77 to 1.80) or the risk of the composite outcome (hazard ratio for the stenting group, 1.10; 95% CI, 0.75 to 1.62). The rates of target-vessel revascularization were significantly higher in the group that received stents than in the group that underwent CABG (hazard ratio, 4.76; 95% CI, 2.80 to 8.11). Comparisons of the group that received bare-metal stents with the group that underwent CABG and of the group that received drug-eluting stents with the group that underwent CABG produced similar results, although there was a trend toward higher rates of death and the composite end point in the group that received drug-eluting stents.
CONCLUSIONS:
In a cohort of patients with unprotected left main coronary artery disease, we found no significant difference in rates of death or of the composite end point of death, Q-wave myocardial infarction, or stroke between patients receiving stents and those undergoing CABG. However, stenting, even with drug-eluting stents, was associated with higher rates of target-vessel revascularization than was CABG.
Copyright 2008 Massachusetts Medical Society.
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