Comparison of Percutaneous Coronary Intervention (With Drug-Eluting Stents) Versus Coronary Artery Bypass Grafting in Women With Severe Narrowing of the Left Main Coronary Artery (from the Women–Drug-Eluting stent for LefT main coronary Artery disease Registry)

Women typically present with coronary artery disease later than men with more unfavorable clinical and anatomic characteristics. It is unknown whether differences exist in women undergoing treatment for unprotected left main coronary artery (ULMCA) disease. Our aim was to evaluate long-term clinical...

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Veröffentlicht in:	The American journal of cardiology 2014-04, Vol.113 (8), p.1348-1355
Hauptverfasser:	Buchanan, Gill Louise, MBChB, Chieffo, Alaide, MD, Meliga, Emanuele, MD, Mehran, Roxana, MD, Park, Seung-Jung, MD, Onuma, Yoshinobu, MD, Capranzano, Piera, MD, Valgimigli, Marco, MD, Narbute, Inga, MD, Makkar, Raj R., MD, Palacios, Igor F., MD, Kim, Young-Hak, MD, Buszman, Piotr P., MD, Chakravarty, Tarun, MD, Sheiban, Imad, MD, Naber, Christoph, MD, Margey, Ronan, MD, Agnihotri, Arvind, MD, Marra, Sebastiano, MD, Capodanno, Davide, MD, PhD, Allgar, Victoria, BSc (Hons), PhD, Leon, Martin B., MD, Moses, Jeffrey W., MD, Fajadet, Jean, MD, Lefevre, Thierry, MD, Morice, Marie-Claude, MD, Erglis, Andrejs, MD, Tamburino, Corrado, MD, PhD, Alfieri, Ottavio, MD, Serruys, Patrick W., MD, Colombo, Antonio, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Angina pectoris Cardiology Cardiovascular Coronary Angiography Coronary Artery Bypass - methods Coronary Stenosis - diagnostic imaging Coronary Stenosis - surgery Coronary vessels Coronary Vessels - surgery Drug-Eluting Stents Female Follow-Up Studies Heart attacks Humans Mortality Percutaneous Coronary Intervention - methods Propensity Score Registries Retrospective Studies Risk Factors Severity of Illness Index Stents Time Factors Treatment Outcome
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Zusammenfassung:	Women typically present with coronary artery disease later than men with more unfavorable clinical and anatomic characteristics. It is unknown whether differences exist in women undergoing treatment for unprotected left main coronary artery (ULMCA) disease. Our aim was to evaluate long-term clinical outcomes in women treated with percutaneous coronary intervention (PCI) with drug-eluting stents versus coronary artery bypass grafting (CABG). All consecutive women from the Drug-Eluting stent for LefT main coronary Artery disease registry with ULMCA disease were analyzed. A propensity matching was performed to adjust for baseline differences. In total, 817 women were included: 489 (59.8%) underwent treatment with PCI with drug-eluting stents versus 328 (40.2%) with CABG. Propensity score matching identified 175 matched pairs, and at long-term follow-up there were no differences in all-cause (odds ratio [OR] 0.722, 95% confidence interval [CI] 0.357 to 1.461, p = 0.365) or cardiovascular (OR 1.100, 95% CI 0.455 to 2.660, p = 0.832) mortality, myocardial infarction (MI; OR 0.362, 95% CI 0.094 to 1.388, p = 0.138), or cerebrovascular accident (CVA; OR 1.200, 95% CI 0.359 to 4.007, p = 0.767) resulting in no difference in the primary study objective of death, MI, or CVA (OR 0.711, 95% CI 0.387 to 1.308, p = 0.273). However, there was an advantage of CABG in major adverse cardiovascular and cerebrovascular events (OR 0.429, 95% CI 0.254 to 0.723, p = 0.001), driven exclusively by target vessel revascularization (OR 0.185, 95% CI 0.079 to 0.432, p
ISSN:	0002-9149 1879-1913
DOI:	10.1016/j.amjcard.2014.01.409