Time-Dependent Impact of Sex on the Long-Term Outcomes After Left Main Revascularization

Background There are still limited data about the differential effect of sex on long-term outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery disease. This extended follow-up study of the MAIN-COMPARE (Ten-Year Outcomes of S...

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Veröffentlicht in:Journal of the American Heart Association 2022-03, Vol.11 (5), p.e021720-e021720
Hauptverfasser: Yoon, Yong-Hoon, Ahn, Jung-Min, Lee, Jung Bok, Kang, Do-Yoon, Park, Hanbit, Jeong, Yeong Jin, Lee, Junghoon, Kim, Ju Hyeon, Yang, Yujin, Hyun, Junho, Lee, Pil Hyung, Park, Duk-Woo, Park, Seung-Jung
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Sprache:eng
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Zusammenfassung:Background There are still limited data about the differential effect of sex on long-term outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery disease. This extended follow-up study of the MAIN-COMPARE (Ten-Year Outcomes of Stents Versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery Disease) registry evaluated clinical outcomes beyond 10 years. Methods and Results Of 2240 patients with unprotected left main coronary artery disease (PCI=1102 and CABG=1138), all-cause mortality, the composite of death, Q-wave myocardial infarction, or stroke, and target vessel revascularization were separately evaluated in both sexes. Of 2240 patients, 631 (28.2%) were women and 1609 (71.8%) were men. Women had lower 10-year incidences of death and serious composite outcomes than men. The adjusted 10-year risks of adverse outcomes were similar in men. However, the adjusted 10-year risks were different according to a prespecified period in women. In the short-term (0-1 year) period, PCI had a significantly lower risk for serious composite outcomes (adjusted hazard ratio [HR], 0.41; 95% CI, 0.19-0.91; =0.03) compared with CABG. The adjusted risks for death and serious composite outcomes were significantly higher after PCI than after CABG, during the midterm (1-5 years) period (death; adjusted HR, 3.99; 95% CI, 2.01-7.92;
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.121.021720