title: Drug-eluting stent for left main coronary artery disease. The DELTA registry: a multicenter registry evaluating percutaneous coronary intervention versus coronary artery bypass grafting for left main treatment.
abstract: OBJECTIVE
  The aim of this study was to compare, in a large all-comers registry, major adverse cardiac and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in unprotected left main coronary artery (ULMCA) stenosis.
  
  
  BACKGROUND
  Percutaneous coronary intervention with DES implantation in ULMCA has been shown to be a feasible and safe approach at midterm clinical follow-up.
  
  
  METHODS
  All consecutive patients with ULMCA stenosis treated by PCI with DES versus CABG were analyzed in this multinational registry. A propensity score analysis was performed to adjust for baseline differences in the overall cohort.
  
  
  RESULTS
  In total 2,775 patients were included: 1,874 were treated with PCI versus 901 with CABG. At 1,295 (interquartile range: 928 to 1,713) days, there were no differences, at the adjusted analysis, in the primary composite endpoint of death, cerebrovascular accidents, and myocardial infarction (MI) (adjusted hazard ratio [HR]: 1.11; 95% confidence interval [CI]: 0.85 to 1.42; p = 0.47), mortality (adjusted HR: 1.16; 95% CI: 0.87 to 1.55; p = 0.32), or composite endpoint of death and MI (adjusted HR: 1.25; 95% CI: 0.95 to 1.64; p = 0.11). An advantage of CABG over PCI was observed in the composite secondary endpoint of MACCE (adjusted HR: 1.64; 95% CI: 1.33 to 2.03; p < 0.0001), driven exclusively by the higher incidence of target vessel revascularization with PCI.
  
  
  CONCLUSIONS
  In our multinational all-comers registry, no difference was observed in the occurrence of death, cerebrovascular accidents, and MI between PCI and CABG. An advantage of CABG over PCI was observed in the incidence of MACCE, driven by the higher incidence of target vessel revascularization with PCI.
authors: Department of Cardio-Thoracic and Vascular Diseases, San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
authors: Alaide
authors: A
authors: Chieffo
authors: Emanuele
authors: E
authors: Meliga
authors: Azeem
authors: A
authors: Latib
authors: Seung-Jung
authors: SJ
authors: Park
authors: Yoshinobu
authors: Y
authors: Onuma
authors: Piera
authors: P
authors: Capranzano
authors: Marco
authors: M
authors: Valgimigli
authors: Sanda
authors: S
authors: Jegere
authors: Raj R
authors: RR
authors: Makkar
authors: Igor F
authors: IF
authors: Palacios
authors: Young-Hak
authors: YH
authors: Kim
authors: Pawel E
authors: PE
authors: Buszman
authors: Tarun
authors: T
authors: Chakravarty
authors: Imad
authors: I
authors: Sheiban
authors: Roxana
authors: R
authors: Mehran
authors: Christoph
authors: C
authors: Naber
authors: Ronan
authors: R
authors: Margey
authors: Arvind
authors: A
authors: Agnihotri
authors: Sebastiano
authors: S
authors: Marra
authors: Davide
authors: D
authors: Capodanno
authors: Martin B
authors: MB
authors: Leon
authors: Jeffrey W
authors: JW
authors: Moses
authors: Jean
authors: J
authors: Fajadet
authors: Thierry
authors: T
authors: Lefevre
authors: Marie-Claude
authors: MC
authors: Morice
authors: Andrejs
authors: A
authors: Erglis
authors: Corrado
authors: C
authors: Tamburino
authors: Ottavio
authors: O
authors: Alfieri
authors: Patrick W
authors: PW
authors: Serruys
authors: Antonio
authors: A
authors: Colombo
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D038622:Internationality; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D016896:Treatment Outcome