title: Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention with second-generation drug-eluting stents for patients with multivessel and unprotected left main coronary artery disease.
abstract: OBJECTIVE
  To compare the efficacy and safety of percutaneous coronary intervention using second-generation drug-eluting stents with those of coronary artery bypass grafting among patients with multivessel disease and/or unprotected left main coronary artery disease in terms of mortality, myocardial infarction, repeat revascularization, and angina.
  
  
  BACKGROUND
  Although coronary artery disease is a leading cause of death in the Western world and in many developing countries, its optimal treatment is still a matter of controversy. Several studies have examined the clinical safety and efficacy of percutaneous coronary intervention using first-generation drug-eluting stents over coronary artery bypass grafting in patients with multivessel disease and/or unprotected left main coronary artery disease. However, this study compared the efficacy of percutaneous coronary intervention using second-generation drug-eluting stents to that of coronary artery bypass grafting for multivessel disease and/or unprotected left main coronary artery disease.
  
  
  METHODS
  This was a prospective single-center cohort study conducted from September 2012 to November 2014 at the Nicosia General Hospital. In total, 140 patients (94% men and 6% women) with chronic coronary artery disease undergoing revascularization with either percutaneous coronary intervention using second-generation drug-eluting stents or coronary artery bypass grafting were evaluated. We examined the differences in clinical outcomes between coronary artery bypass grafting and percutaneous coronary intervention at 1-year follow-up.
  
  
  RESULTS
  Percutaneous coronary intervention with second-generation drug-eluting stents as opposed to coronary artery bypass grafting resulted in similar rates of mortality (5.7% vs 11.4%, respectively; p = 0.135), myocardial infarction (0% vs 4.3%, respectively), repeat revascularization (4.3% vs 8.6%, respectively; p = 0.115) and angina (10% vs 18.6%, respectively; p = 0.153).
  
  
  CONCLUSIONS
  In this patient population, percutaneous coronary intervention with second-generation drug-eluting stents was not inferior to coronary artery bypass grafting in terms of mortality, myocardial infarction, repeat revascularization, or angina.
authors.affiliation: Cardiology Department, Medical Check-Up Centre, Nicosia, Cyprus.
authors.forename: Kyriacos
authors.initials: K
authors.lastname: Papadopoulos
authors.affiliation: Cardiology Department, Attikon University Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Lekakis
authors.affiliation: Saint George's Medical School, University of Nicosia Medical School, Nicosia, Cyprus.
authors.forename: Evagoras
authors.initials: E
authors.lastname: Nicolaides
keywords: Coronary artery bypass grafting; coronary artery disease; drug-eluting stents; percutaneous coronary intervention