title: A comparison between coronary artery bypass grafting surgery and drug eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged > or =75 years).
abstract: OBJECTIVE
  In this study, we compared the clinical outcomes of elderly patients with unprotected left main coronary artery (ULMCA) stenosis treated with either coronary artery bypass grafting (CABG) or drug-eluting stent (DES).
  
  
  RESULTS
  From January 2003 to April 2006, 259 patients with ULMCA stenosis and age > or =75 years underwent coronary revascularization with either CABG or DES. One hundred and sixty-one patients were treated with CABG and 98 with DES. The cumulative unadjusted rates of 2-year mortality were 17% in CABG-treated patients and 18% in those treated with DES (P = 0.71). The adjusted rates of 2-year survival were 85% for CABG-treated patients and 87% for DES-treated patients (P = 0.74). The incidence of 2-year myocardial infarction was 6% in CABG-treated patients and 4% in DES-treated patients (P = 0.11). The incidence of target lesion revascularization (TLR) was 3% in CABG-treated patients and 25% in DES-treated patients (P < 0.0001). In the multivariable analysis, peripheral vascular disease, left ventricular ejection fraction and acute coronary syndrome were independent predictors of 2-year mortality.
  
  
  CONCLUSIONS
  In this study, we could not demonstrate a difference in mortality between CABG-treated patients and those treated with DES. However, the rate of TLR was higher in the DES group.
authors: Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola, Via Massarenti 9, 40 138 Bologna, Italy. tulliopalmerini@hotmail.com
authors: Tullio
authors: T
authors: Palmerini
authors: Fabio
authors: F
authors: Barlocco
authors: Andrea
authors: A
authors: Santarelli
authors: Letizia
authors: L
authors: Bacchi-Reggiani
authors: Carlo
authors: C
authors: Savini
authors: Elisa
authors: E
authors: Baldini
authors: Laura
authors: L
authors: Alessi
authors: Michele
authors: M
authors: Ruffini
authors: Germano
authors: G
authors: Di Credico
authors: Giancarlo
authors: G
authors: Piovaccari
authors: Roberto
authors: R
authors: Di Bartolomeo
authors: Antonio
authors: A
authors: Marzocchi
authors: Angelo
authors: A
authors: Branzi
authors: Stefano
authors: S
authors: De Servi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality; D023921:Coronary Stenosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D016019:Survival Analysis; D016896:Treatment Outcome