Percutaneous coronary intervention or coronary artery bypass graft surgery for left main coronary artery disease: A meta-analysis of randomized trials - 25/08/20

Doi : 10.1016/j.ahj.2020.06.001

Toshiki Kuno, MD, PhD ^a, Hiroki Ueyama, MD ^a, Sunil V. Rao, MD ^b, Mauricio G. Cohen, MD ^c, Jacqueline E. Tamis-Holland, MD ^d, Craig Thompson, MD ^e, Hisato Takagi, MD, PhD ^f, Sripal Bangalore, MD, MHA ^e,^{^⁎}
^a Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY
^b Duke Clinical Research Institute, Durham, NC
^c Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL
^d Mount Sinai Saint Luke's Hospital, New York, NY
^e Division of Cardiovascular Medicine, New York University School of Medicine, New York, NY
^f Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan

^⁎Reprint requests: Sripal Bangalore, MD, MHA, Professor of Medicine, Division of Cardiovascular Medicine, New York University School of Medicine, New York, NY 10016.Division of Cardiovascular MedicineNew York University School of MedicineNew YorkNY10016

Abstract

We aimed to investigate long-term (≥5 years) outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) using a meta-analysis from updated published randomized trials. Our data showed that the risk of all-cause death as well as cardiovascular death, myocardial infarction, and stroke was similar between PCI and CABG, whereas PCI had significantly higher rates of repeat revascularization compared to CABG. Decisions for PCI versus CABG for LMCAD should be based on weighing the upfront morbidity and mortality risk of CABG with late risk of repeat revascularization with PCI and taking into consideration patient preference.

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☆	Disclosure: Dr Bangalore is an advisory board member for Abbott Vascular, Biotronik, Amgen, Pfizer, and Reata. Dr Cohen is a consultant for AstraZeneca, Medtronic, Merit Medical, Terumo Medical, and Abiomed. The remaining authors have nothing to disclose.
☆☆	Kim A. Eagle, MD, served as guest editor for this article.

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Vol 227

P. 9-10 - settembre 2020 Ritorno al numero

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P2Y12 inhibitor monotherapy versus aspirin monotherapy after short-term dual antiplatelet therapy for percutaneous coronary intervention: Insights from a network meta-analysis of randomized trials
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Percutaneous coronary intervention or coronary artery bypass graft surgery for left main coronary artery disease: A meta-analysis of randomized trials - 25/08/20

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