title: Percutaneous treatment with drug-eluting stent vs bypass surgery in patients suffering from chronic stable angina with multivessel disease involving significant proximal stenosis in left anterior descending artery.
abstract: BACKGROUND
  The aim of the present study was to compare the effects of drug-eluting stents (DES) and coronary artery bypass grafting (CABG) in patients suffering from chronic stable angina with multivessel disease, involving significant proximal stenosis in the left anterior descending artery (LAD).
  
  
  RESULTS
  All consecutive patients suffering from chronic stable angina with multivessel disease involving significant proximal LAD stenosis underwent DES implantation (n=600) or CABG (n=709) at our institution. At 2 years, the unadjusted mortality was significantly lower in the DES group than in the CABG group (2.2% vs 5.2%, P=0.004), but the adjusted risk of death was similar (odds ratio (OR) 0.74, 95%CI 0.28-1.97, P=0.555). Furthermore, both the adjusted rate of nonfatal myocardial infarction and cerebrovascular events was also comparable. However, the unadjusted and adjusted risk of major adverse cardiac cerebrovascular events in the DES was significantly higher than in the CABG (13.3% vs 9.6%, OR 2.71, 95%CI 1.56-4.74, P<0.001), which is probably attributed to the higher subsequent revascularization rate after DES implantation.
  
  
  CONCLUSIONS
  DES showed comparable long-term mortality for the treatment of multivessel disease involving significant proximal stenosis in LAD in comparison with CABG.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Yan
authors.forename: Ma
authors.initials: M
authors.lastname: Changsheng
authors.forename: Nie
authors.initials: N
authors.lastname: Shaoping
authors.forename: Liu
authors.initials: L
authors.lastname: Xiaohui
authors.forename: Kang
authors.initials: K
authors.lastname: Junping
authors.forename: Lv
authors.initials: L
authors.lastname: Qiang
authors.forename: Du
authors.initials: D
authors.lastname: Xin
authors.forename: Hu
authors.initials: H
authors.lastname: Rong
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yin
authors.forename: Jia
authors.initials: J
authors.lastname: Changqi
authors.forename: Wu
authors.initials: W
authors.lastname: Jiahui
authors.forename: Liu
authors.initials: L
authors.lastname: Xinmin
authors.forename: Dong
authors.initials: D
authors.lastname: Jianzeng
authors.forename: Chen
authors.initials: C
authors.lastname: Fang
authors.forename: Zhou
authors.initials: Z
authors.lastname: Yujie
authors.forename: Lv
authors.initials: L
authors.lastname: Shuzheng
authors.forename: Huang
authors.initials: H
authors.lastname: Fangjiong
authors.forename: Gu
authors.initials: G
authors.lastname: Chengxiong
authors.forename: Wu
authors.initials: W
authors.lastname: Xuesi
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002561:Cerebrovascular Disorders / Q000209:etiology; D002908:Chronic Disease; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D016017:Odds Ratio; D017239:Paclitaxel / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors; D017239:Paclitaxel; D020123:Sirolimus