title: [Percutaneous coronary intervention of unprotected left main coronary compared with coronary artery bypass grafting; 3 years of experience in the National Institute of Cardiology, Mexico].
abstract: BACKGROUND
  The best revascularisation method of the unprotected left main artery is a current and evolving topic.
  
  
  METHODS
  A total of 2439 percutaneous coronary interventions (PCI) were registered during a 3-year period. The study included all the patients with PCI of the unprotected left main coronary (n=48) and matched with patients who underwent coronary artery bypass graft (CABG) (n=50). Major adverse cerebral and cardiac events (MACCE) were assessed within the hospital and in outpatients during a 16 month follow up.
  
  
  RESULTS
  The cardiovascular risk was greater in the PCI group; logEuroSCORE 16±21 vs. 5±6, P=.001; clinical Syntax 77±74 vs 53±39, P=.04. On admission, the PCI group of patients had a higher frequency of ST segment elevation myocardial infarction (STEMI) and cardiogenic shock. The MACCE were similar in both groups (14% vs. 18%, P=.64). STEMI was less frequent in the PCI group (0% vs. 10%, P=.03). Cardiovascular events were lower in the PCI group (2.3% vs. 18%, P=.01), and there was a decrease in general and cardiac mortality (2.3% vs. 12%, P=.08 y 2.3% vs. 8%, P=.24), on excluding the patients with cardiogenic shock as a presentation. MACCE were similar in both groups in the out-patient phase (15% vs. 12%, P=.46). Survival without MACCE, general and cardiac death were comparable between groups (log rank, P=.38, P=.44 and P=.16, respectively).
  
  
  CONCLUSIONS
  Even though the clinical and peri-procedural risk profile of the PCI patients were higher, the in-hospital and out-hospital efficacy and safety were comparable with CABG.
authors.affiliation: Servicio de Angiografía, Hospital Eugenio Espejo, Av. Gran Colombia SN y Yaguachi, Quito, Ecuador. Electronic address: lopezaguilarc@yahoo.com.mx.
authors.forename: Carlos
authors.initials: C
authors.lastname: López-Aguilar
authors.affiliation: Departamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Dr. Ignacio Chávez, Juan Badiano N1, Sección XVI, del Tlalpan, C.P. 14080, Ciudad de México, México.
authors.forename: Arturo
authors.initials: A
authors.lastname: Abundes-Velasco
authors.affiliation: Departamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Dr. Ignacio Chávez, Juan Badiano N1, Sección XVI, del Tlalpan, C.P. 14080, Ciudad de México, México.
authors.forename: Guering
authors.initials: G
authors.lastname: Eid-Lidt
authors.affiliation: Departamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Dr. Ignacio Chávez, Juan Badiano N1, Sección XVI, del Tlalpan, C.P. 14080, Ciudad de México, México.
authors.forename: Yigal
authors.initials: Y
authors.lastname: Piña-Reyna
authors.affiliation: Departamento de Cardiología Intervencionista, Instituto Nacional de Cardiología Dr. Ignacio Chávez, Juan Badiano N1, Sección XVI, del Tlalpan, C.P. 14080, Ciudad de México, México.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gaspar-Hernández
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cirugía de revascularización coronaria; Coronary artery bypass grafting; Efficacy; Eficacia; Intervencionismo coronario percutáneo; Mexico; México; Percutaneous coronary intervention; Safety; Seguridad; Tronco no protegido de coronaria izquierda; Unprotected left main coronary artery