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Midterm outcome of off-pump bypass procedures versus drug-eluting stent for unprotected left main coronary artery disease

DC FieldValueLanguage
dc.contributor.author송석원-
dc.contributor.author유경종-
dc.contributor.author윤영남-
dc.contributor.author이기종-
dc.contributor.author홍순창-
dc.date.accessioned2014-12-19T16:27:37Z-
dc.date.available2014-12-19T16:27:37Z-
dc.date.issued2012-
dc.identifier.issn0003-4975-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/89568-
dc.description.abstractBACKGROUND: Although surgical revascularization is recommended for the treatment of left main coronary artery (LMCA) disease, percutaneous coronary intervention (PCI) attempts have increased, especially after the introduction of the drug-eluting stent. The goal of this study was to compare the midterm outcomes between drug-eluting stenting and off-pump coronary artery bypass (OPCAB) grafting in LMCA disease. METHODS: Five hundred twelve consecutive patients with unprotected LMCA disease who underwent OPCAB (N = 269) or drug-eluting stenting (N = 243) were enrolled. We compared major cardiac and cerebrovascular events (MACCEs) in a real-world cohort and in a matching patient cohort (N = 256). The duration of mean follow-up was 38 ± 20 months, and the follow-up rate was 97.7%. RESULTS: In a real-world comparison, the OPCAB group showed better 5-year freedom from MACCEs compared with the stenting group (71.5% ± 4.4% versus 67.6% ± 4.0%; p = 0.031), despite worse patient characteristics. After patient matching, the OPCAB group showed more distinct benefit in 5-year freedom from MACCEs (75.3% ± 6.6% versus 62.8% ± 5.4; p < 0.001), including a significantly lower target vessel revascularization (TVR) rate (p < 0.001). In a subgroup analysis, the benefit of OPCAB regarding 5-year freedom from MACCEs was more clearly defined for lesions of the distal LCMA and in LMCA lesions with multivessel disease (p = 0.015, p = 0.004, respectively). CONCLUSIONS: Patients with LMCA disease who were treated with OPCAB showed better 5-year freedom from MACCEs in a real-world practice and in a patient matching cohort compared with the drug-eluting stenting group. TVR was the main factor that made the difference. The benefit of OPCAB was more prominent in distal LMCA lesions and in LMCA lesions with multivessel involvement.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfAnnals of Thoracic Surgery-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleMidterm outcome of off-pump bypass procedures versus drug-eluting stent for unprotected left main coronary artery disease-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Thoracic & Cardiovascular Surgery (흉부외과학)-
dc.contributor.googleauthorGijong Yi-
dc.contributor.googleauthorYoung-Nam Youn-
dc.contributor.googleauthorSoonchang Hong-
dc.contributor.googleauthorSuk-Won Song-
dc.contributor.googleauthorKyung-Jong Yoo-
dc.identifier.doi10.1016/j.athoracsur.2012.03.029-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA02028-
dc.contributor.localIdA02453-
dc.contributor.localIdA02576-
dc.contributor.localIdA02697-
dc.contributor.localIdA04412-
dc.relation.journalcodeJ00183-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0003497512006467-
dc.contributor.alternativeNameSong, Suk Won-
dc.contributor.alternativeNameYoo, Kyung Jong-
dc.contributor.alternativeNameYoun, Young Nam-
dc.contributor.alternativeNameYi, Gi Jong-
dc.contributor.alternativeNameHong, Soon Chang-
dc.contributor.affiliatedAuthorSong, Suk Won-
dc.contributor.affiliatedAuthorYoo, Kyung Jong-
dc.contributor.affiliatedAuthorYoun, Young Nam-
dc.contributor.affiliatedAuthorYi, Gi Jong-
dc.contributor.affiliatedAuthorHong, Soon Chang-
dc.citation.volume94-
dc.citation.number1-
dc.citation.startPage15-
dc.citation.endPage22-
dc.identifier.bibliographicCitationAnnals of Thoracic Surgery, Vol.94(1) : 15-22, 2012-
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)

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