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• W2912602291 abstract "Abstract Background Little is known about how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary‐artery bypass grafting (CABG) on clinical outcomes in ostial or shaft left main coronary artery (LMCA) disease has evolved over time. Methods This study included 2,112 patients with ostial or shaft LMCA disease from IRIS‐MAIN registry who underwent PCI ( n = 1,329) or CABG ( n = 783). Patients were stratified by time period based on stent type availability: wave 1 (1995–2002, bare‐metal stent [BMS] era); wave 2 (2003–2006, first‐generation drug‐eluting stent [DES] era); and wave 3 (2007–2014, second‐generation DES era). Results Compared to CABG, PCI has been used more frequently from wave 1 to wave 3. PCI showed substantial improvements over time with respect to death ( P for trend = 0.012); the composite of death, myocardial infarction (MI), or stroke ( P for trend = 0.047); repeat revascularization ( P for trend < 0.001); and major adverse cardiac and cerebrovascular events (MACCE; a composite of death, MI, stroke, or repeat revascularization) ( P for trend < 0.001). By contrast, outcomes of CABG remained relatively stable over time. The gap between the treatment effects of CABG vs PCI for MACCE has narrowed over time; the adjusted hazard ratios for CABG compared to PCI during wave 1, 2, and 3 were 0.41 (95% confidence interval [CI]: 0.22–0.76), 0.47 (95% CI: 0.31–0.71), and 0.78 (95% CI: 0.50–1.20), respectively. Conclusions In patients with ostial or shaft LMCA disease, significant improvements in PCI outcomes resulted in a progressive decline in the gap between the outcomes of CABG and PCI." @default.
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• W2912602291 date "2019-02-05" @default.
• W2912602291 modified "2023-10-18" @default.
• W2912602291 title "Long‐term trends of treatment effect of stenting or bypass surgery in patients with ostial or shaft left main coronary artery disease" @default.
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• W2912602291 doi "https://doi.org/10.1002/ccd.28119" @default.
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