title: Long-term clinical outcomes after percutaneous coronary intervention versus coronary artery bypass grafting for acute coronary syndrome from the DELTA registry: a multicentre registry evaluating percutaneous coronary intervention versus coronary artery bypass grafting for left main treatment.
abstract: OBJECTIVE
  Our aim was to compare, in a large unprotected left main coronary artery (ULMCA) all-comer registry, the long-term clinical outcome after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS).
  
  
  RESULTS
  Of a total of 2,775 patients enrolled in the Drug Eluting Stents for Left Main Coronary Artery Disease (DELTA) multicentre registry, 379 (13.7%) patients with ACS treated with PCI (n=272) or CABG (n=107) were analysed. Baseline demographics were considerably different in the two groups before propensity matching. No significant differences emerged for the composite endpoint of all-cause death, myocardial infarction (MI), and cerebrovascular accident (HR 1.11, 95% CI: 0.63-1.94; p=0.727), all-cause death (HR 1.26, 95% CI: 0.68-2.32; p=0.462), the composite endpoint of all-cause death and MI (HR 1.02, 95% CI: 0.56-1.84; p=0.956), and major adverse cardiac and cerebrovascular events (HR 0.82, 95% CI: 0.50-1.36; p=0.821). However, a higher incidence of target vessel revascularisation (HR 4.67, 95% CI: 1.33-16.47; p=0.008) was observed in the PCI compared with the CABG group, which was confirmed in the propensity score-matched analysis.
  
  
  CONCLUSIONS
  In the DELTA all-comer, multinational registry, PCI for ACS in ULMCA is associated with comparable clinical outcomes to those observed with CABG at long-term follow-up, despite the use of first-generation DES.
authors: Contilia Heart and Vascular Center, Elisabeth-Krankenhaus Essen, Essen, Germany.
authors: Stylianos A
authors: SA
authors: Pyxaras
authors: Lukas
authors: L
authors: Hunziker
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: Inga
authors: I
authors: Narbute
authors: Raj R
authors: RR
authors: Makkar
authors: Igor F
authors: IF
authors: Palacios
authors: Young-Hak
authors: YH
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authors: Piotr P
authors: PP
authors: Buszman
authors: Tarun
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authors: Chakravarty
authors: Imad
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authors: Sheiban
authors: Roxana
authors: R
authors: Mehran
authors: Ronan
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authors: Margey
authors: Arvind
authors: A
authors: Agnihotri
authors: Sebastiano
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authors: Marra
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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
authors: Christoph K
authors: CK
authors: Naber
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012042:Registries; D020521:Stroke; D016896:Treatment Outcome