PMID- 23492989
OWN - NLM
STAT- MEDLINE
DCOM- 20140703
LR  - 20131011
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 44
IP  - 5
DP  - 2013 Nov
TI  - Five-year follow-up of drug-eluting stents implantation vs minimally invasive 
      direct coronary artery bypass for left anterior descending artery disease: a 
      propensity score analysis.
PG  - 884-90
LID - 10.1093/ejcts/ezt137 [doi]
AB  - OBJECTIVES: The spread of drug-eluting stents (DES) has reduced the incidence of 
      early restenosis following percutaneous coronary interventions (PCI). Meanwhile, 
      development of minimally invasive coronary artery bypass surgery (MIDCAB) has 
      offered a valuable alternative to conventional sternotomy with preservation of 
      the benefit of the internal mammary artery use. Therefore, the revascularization 
      of the left anterior descending (LAD) artery is suitable for both techniques. 
      However, few data with long-term comparison of these two techniques exist. 
      METHODS: Prospective data were collected for 456 patients undergoing isolated LAD 
      revascularization between 1997 and 2011. Two hundred and sixty patients were 
      treated with MIDCAB and 196 with first-generation DES implantation. A propensity 
      score model was created to adjust for 19 relevant confounding variables. Primary 
      and secondary end-points were, respectively, 5-year survival and freedom from 
      major adverse cerebro-cardiovascular events (MACCE). RESULTS: Both groups were 
      similar in age, EuroSCORE and mean duration of follow-up. Five-year survival was 
      similar after MIDCAB or DES (hazard ratio (HR): 0.95; P = 0.89). Freedom from 
      MACCE was significantly in favour of the MIDCAB group (HR: 0.32, P < 0.0001), 
      mainly triggered by high subsequent need for revascularization of the targeted 
      vessel in the DES group (HR: 0.17, P < 0.0001). CONCLUSIONS: MIDCAB and DES 
      implantation showed similar rates of survival but despite an expected lower rate 
      of reintervention on the targeted vessel with DES use, a highly significant 
      higher MACCE rate was observed in the PCI group at 5-year follow-up.
FAU - Etienne, Pierre Yves
AU  - Etienne PY
AD  - Clinique St Luc, Namur, Belgium.
FAU - D'hoore, William
AU  - D'hoore W
FAU - Papadatos, Spiridon
AU  - Papadatos S
FAU - Mairy, Yves
AU  - Mairy Y
FAU - El Khoury, Gebrine
AU  - El Khoury G
FAU - Noirhomme, Philippe
AU  - Noirhomme P
FAU - Hanet, Claude
AU  - Hanet C
FAU - Glineur, David
AU  - Glineur D
LA  - eng
PT  - Journal Article
DEP - 20130314
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Blood Vessel Prosthesis Implantation/adverse effects/*methods
MH  - Coronary Artery Bypass/adverse effects/*methods
MH  - Coronary Artery Disease/*surgery
MH  - Coronary Vessels/surgery
MH  - *Drug-Eluting Stents
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Morbidity
MH  - Postoperative Complications
MH  - Propensity Score
OTO - NOTNLM
OT  - Bypass
OT  - Coronary disease
OT  - Internal thoracic artery
OT  - Stent
OT  - Surgery
EDAT- 2013/03/16 06:00
MHDA- 2014/07/06 06:00
CRDT- 2013/03/16 06:00
PHST- 2013/03/16 06:00 [entrez]
PHST- 2013/03/16 06:00 [pubmed]
PHST- 2014/07/06 06:00 [medline]
AID - ezt137 [pii]
AID - 10.1093/ejcts/ezt137 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2013 Nov;44(5):884-90. doi: 10.1093/ejcts/ezt137. Epub 
      2013 Mar 14.