title: Comparison of coronary artery bypass grafting with percutaneous coronary intervention for unprotected left main coronary artery disease.
abstract: OBJECTIVE
  Coronary artery bypass grafting (CABG) is the optimal treatment option for left main coronary artery disease (LMCAD). However, LMCAD remains a constant topic of discussion between cardiac surgeons and interventional cardiologists. The aim of this study was to assess the efficacy of LMCAD treatments by comparing the mid-term outcomes of CABG and percutaneous coronary intervention (PCI) using bare metal stents or drug-eluting stents (DESs).
  
  
  METHODS
  The study population was comprised of 199 consecutive patients admitted with unprotected LMCAD. All of the patients were assigned to PCI (88 patients) or CABG (111 patients). The primary clinical end point indicated death, stroke of acute coronary syndrome (ACS).
  
  
  RESULTS
  Patients assigned to PCI were at higher operative risk than patients scheduled for CABG (6.49 ± 4.09 vs. 4.81 ± 2.67, p=0.0032). Comparison of the group that received DESs with the CABG group did not reveal any differences in major adverse cardio-cerebral events (MACCE) occurrence (21% vs. 16%, p=NS). Patients in the CABG and PCI groups died with similar frequency (11% vs. 16%, p=NS). The mortality rate in the CABG group was higher than among those treated with DES (11% vs. 3%, p=0.049). The rate of ACS was higher in the PCI group than in the CABG group (13% vs. 4%, p=0.016).
  
  
  CONCLUSIONS
  Despite the fact that patients treated with PCI were at higher operative risk, PCI with DES was shown to be comparable to CABG in terms of mortality, stroke and ACS. However, the frequency of repeat revascularizations remains a constant concern with PCI.
authors.affiliation: 2nd Department of Cardiology, Zabrze, Medical University of Silesia, Katowice, 10 M. Curie-Skłodowskiej Str., 41-800 Zabrze, Poland. d.kawecki@interia.pl
authors.forename: Damian
authors.initials: D
authors.lastname: Kawecki
authors.forename: Beata
authors.initials: B
authors.lastname: Morawiec
authors.forename: Marcin
authors.initials: M
authors.lastname: Fudal
authors.forename: Wojciech
authors.initials: W
authors.lastname: Milejski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jacheć
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowalany-Kozielska
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery / Q000628:therapy; D003331:Coronary Vessels; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals