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Effects of Coronary Artery Revascularization with a Polymer-Free Biolimus A9-Coated BioFreedom Stent Versus Bypass Surgery before Noncardiac Surgery

Authors
 Kyu Kim  ;  Choongki Kim  ;  Byeong Keuk Kim  ;  Ji Yong Jang  ;  Ae Young Her  ;  Seunghwan Kim  ;  Sung Jin Hong  ;  Chul Min Ahn  ;  Jung Sun Kim  ;  Young Guk Ko  ;  Donghoon Choi  ;  Myeong Ki Hong  ;  Yangsoo Jang 
Citation
 Yonsei Medical Journal, Vol.59(4) : 480-488, 2018 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2018
MeSH
Aged ; *Coronary Artery Bypass ; Coronary Artery Disease/diagnostic imaging/*drug therapy/surgery ; *Drug-Eluting Stents/adverse effects ; Female ; Hemorrhage/*chemically induced ; Humans ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Sirolimus/administration & dosage/*analogs & derivatives ; Stroke/etiology ; Treatment Outcome
Keywords
Percutaneous coronary intervention ; coronary artery bypass ; drug-coated stent ; preoperative care
Abstract
PURPOSE: The present study aimed to evaluate the efficacy and safety of polymer-free drug-coated BioFreedom stent implantation in comparison to coronary artery bypass graft (CABG) before major noncardiac surgery. MATERIALS AND METHODS: In a multicenter registry, 55 patients required revascularization before major noncardiac surgery that should not be delayed >6 months. Of them, 27 underwent BioFreedom stent implantation and 28 underwent CABG. Primary outcomes included rate of noncardiac surgery, time from revascularization to noncardiac surgery, and occurrence of composite outcomes (all-cause death, myocardial infarction, stent thrombosis, stroke, repeat revascularization, or major bleeding). RESULTS: The rate of major noncardiac surgery was significantly higher in the BioFreedom group (92.6%) than in the CABG group (64.3%; p=0.027). Time from revascularization to noncardiac surgery was significantly shorter in the BioFreedom group (38.0 days) than in the CABG group (73.0 days; p=0.042). During the hospitalization for revascularization period, the occurrence of primary outcomes did not differ between the groups. However, the BioFreedom group showed a shorter hospitalization period and lower total treatment cost than the CABG group. During the hospital stay for noncardiac surgery, the occurrence of composite outcome was not significantly different between groups (4% vs. 0%; p>0.999): stroke occurred in only 1 case, and there were no cases of death or stent thrombosis in the BioFreedom group. CONCLUSION: This study demonstrated that BioFreedom stenting as a revascularization strategy before major noncardiac surgery might be feasible and safe in selected patients with less severe coronary artery diseases.
Files in This Item:
T201801530.pdf Download
DOI
10.3349/ymj.2018.59.4.480
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk)
김규(Kim, Kyu)
김병극(Kim, Byeong Keuk) ORCID logo https://orcid.org/0000-0003-2493-066X
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
김충기(Kim, Choong Ki)
안철민(Ahn, Chul-Min) ORCID logo https://orcid.org/0000-0002-7071-4370
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
홍명기(Hong, Myeong Ki) ORCID logo https://orcid.org/0000-0002-2090-2031
홍성진(Hong, Sung Jin) ORCID logo https://orcid.org/0000-0003-4893-039X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162411
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