Bypass surgery versus percutaneous coronary intervention for the treatment of unprotected left main disease

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• 作者：PD Dr. S. Desch (1)
  E. Boudriot (1)
  A. Rastan (2)
  P.E. Buszman (3)
  A. Bochenek (4)
  F.W. Mohr (2)
  G. Schuler (1)
  H. Thiele (1)
  
• 关键词：Left main stenosis ; Coronary artery bypass surgery ; Percutaneous coronary intervention ; Stent ; Meta ; analysis ; Ungeschützte Hauptstammstenose ; Bypass ; Chirurgie ; Perkutane Koronarintervention ; Stent ; Metaanalyse
• 刊名：Herz
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：38
• 期：1
• 页码：48-56
• 全文大小：566KB
• 参考文献：1. Caracciolo EA, Davis KB, Sopko G, Kaiser GC (1995) Comparison of surgical and medical group survival in patients with left main equivalent coronary artery disease. Long-term CASS experience. Circulation 91:2335-344 CrossRef
  2. Chaitman BR, Fisher LD, Bourassa MG, Davis K (1981) Effect of coronary bypass surgery on survival patterns in subsets of patients with left main coronary artery disease. Report of the collaborative study in coronary artery surgery (CASS). Am J Cardiol 48:765-77 CrossRef
  3. Levine GN, Bates ER, Blankenship JC, Bailey SR (2011) 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 124:e574-51 CrossRef
  4. Higgins JPT, Altman DG (2008) Assessing risk of bias in included studies. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley, Chichester, pp?187-41
  5. Sterne J, Egger M, Moher D (2008) Addressing reporting biases. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley, Chichester, pp?297-33
  6. Liberati A, Altman DG, Tetzlaff J, Mulrow C (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700 CrossRef
  7. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535 CrossRef
  8. Boudriot E, Thiele H, Walther T, Liebetrau C (2011) Randomized comparison of percutaneous coronary intervention with sirolimus-eluting stents versus coronary artery bypass grafting in unprotected left main stem stenosis. J Am Coll Cardiol 57:538-45 CrossRef
  9. Buszman PE, Kiesz SR, Bochenek A, Peszek-Przybyla E (2008) Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization. J Am Coll Cardiol 51:538-45 CrossRef
  10. Kappetein AP on behalf of the Syntax investigators (2009) The 2-year outcomes of the Syntax trial. Presented at ESC
  11. Park SJ, Kim YH, Park DW, Yun SC (2011) Randomized trial of stents versus bypass surgery for left main coronary artery disease. N Engl J Med 364:1718-727 CrossRef
  12. Biryukova E, Williams FM, Valencia O, Kaski JC (2010) Comparison of mid-term outcome in patients with three-vessel and/or left main disease undergoing percutaneous coronary intervention and coronary artery bypass graft surgery. Eur J Cardiothorac Surg 37:905-11 CrossRef
  13. Brener SJ, Galla JM, Bryant R 3rd, Sabik JF 3rd (2008) Comparison of percutaneous versus surgical revascularization of severe unprotected left main coronary stenosis in matched patients. Am J Cardiol 101:169-72 CrossRef
  14. Cheng CI, Lee FY, Chang JP, Hsueh SK (2009) Long-term outcomes of intervention for unprotected left main coronary artery stenosis: coronary stenting vs coronary artery bypass grafting. Circ J 73:705-12 CrossRef
  15. Chieffo A, Magni V, Latib A, Maisano F (2010) 5-year outcomes following percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass graft for unprotected left main coronary artery lesions the Milan experience. JACC Cardiovasc Interv 3:595-01 CrossRef
  16. Chieffo A, Morici N, Maisano F, Bonizzoni E (2006) Percutaneous treatment with drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis: a single-center experience. Circulation 113:2542-547 CrossRef
  17. Ghenim R, Roncalli J, Tidjane AM, Bongard V (2009) One-year follow-up of nonrandomized comparison between coronary artery bypass grafting surgery and drug-eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged > or =-5 years). J Interv Cardiol 22:520-26 CrossRef
  18. Gziut A, Gil R, Kulawik T (2010) Comparative analysis of conservative, percutaneous, and surgical treatment outcomes in patients with significant stenosis of the left main coronary artery during five-year follow-up. Kardiol Pol 68:381-90
  19. Hsu JT, Chu CM, Chang ST, Kao CL (2008) Percutaneous coronary intervention versus coronary artery bypass graft surgery for the treatment of unprotected left main coronary artery stenosis: in-hospital and one year outcome after emergent and elective treatments. Int Heart J 49:355-70 CrossRef
  20. Kang SH, Park KH, Choi DJ, Park KW (2010) Coronary artery bypass grafting versus drug-eluting stent implantation for left main coronary artery disease (from a two-center registry). Am J Cardiol 105:343-51 CrossRef
  21. Lee MS, Kapoor N, Jamal F, Czer L (2006) Comparison of coronary artery bypass surgery with percutaneous coronary intervention with drug-eluting stents for unprotected left main coronary artery disease. J Am Coll Cardiol 47:864-70 CrossRef
  22. Liu YY, Zhou YJ, Wang ZJ, Shi DM (2009) Comparison between drug eluting stent and coronary artery bypass grafting surgery for the treatment of unprotected left main coronary artery disease in elderly patients. Zhonghua Xin Xue Guan Bing Za Zhi 37:769-72
  23. Makikallio TH, Niemela M, Kervinen K, Jokinen V (2008) Coronary angioplasty in drug eluting stent era for the treatment of unprotected left main stenosis compared to coronary artery bypass grafting. Ann Med 40:437-43 CrossRef
  24. Palmerini T, Barlocco F, Santarelli A, Bacchi-Reggiani L (2007) A comparison between coronary artery bypass grafting surgery and drug eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged > or =-5 years). Eur Heart J 28:2714-719 CrossRef
  25. Palmerini T, Marzocchi A, Marrozzini C, Ortolani P (2006) Comparison between coronary angioplasty and coronary artery bypass surgery for the treatment of unprotected left main coronary artery stenosis (the Bologna registry). Am J Cardiol 98:54-9 CrossRef
  26. Park DW, Kim YH, Yun SC, Lee JY (2010) Long-term outcomes after stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 10-year results of bare-metal stents and 5-year results of drug-eluting stents from the ASAN-MAIN (ASAN Medical Center-Left MAIN Revascularization) Registry. J Am Coll Cardiol 56:1366-375 CrossRef
  27. Park DW, Seung KB, Kim YH, Lee JY (2010) Long-term safety and efficacy of stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 5-year results from the Main-Compare (revascularization for unprotected left main coronary artery stenosis: comparison of percutaneous coronary angioplasty versus surgical revascularization) registry. J Am Coll Cardiol 56:117-24 CrossRef
  28. Rittger H, Rieber J, Kogler K, Sinha A (2010) Clinical outcome and quality of life after interventional treatment of left main disease with drug-eluting-stents in comparison to CABG in elderly and younger patients. Clin Res Cardiol 100:439-46 CrossRef
  29. Rodes-Cabau J, Deblois J, Bertrand OF, Mohammadi S (2008) Nonrandomized comparison of coronary artery bypass surgery and percutaneous coronary intervention for the treatment of unprotected left main coronary artery disease in octogenarians. Circulation 118:2374-381 CrossRef
  30. Sanmartin M, Baz JA, Claro R, Asorey V (2007) Comparison of drug-eluting stents versus surgery for unprotected left main coronary artery disease. Am J Cardiol 100:970-73 CrossRef
  31. Seung KB, Park DW, Kim YH, Lee SW (2008) Stents versus coronary-artery bypass grafting for left main coronary artery disease. N Engl J Med 358:1781-792 CrossRef
  32. Shimizu T, Ohno T, Ando J, Fujita H (2010) Mid-term results and costs of coronary artery bypass vs drug-eluting stents for unprotected left main coronary artery disease. Circ J 74:449-55 CrossRef
  33. White AJ, Kedia G, Mirocha JM, Lee MS (2008) Comparison of coronary artery bypass surgery and percutaneous drug-eluting stent implantation for treatment of left main coronary artery stenosis. JACC Cardiovasc Interv 1:236-45 CrossRef
  34. Wu C, Hannan EL, Walford G, Faxon DP (2008) Utilization and outcomes of unprotected left main coronary artery stenting and coronary artery bypass graft surgery. Ann Thorac Surg 86:1153-159 CrossRef
  35. Wu X, Chen Y, Liu H, Teirstein PS (2010) Comparison of long-term (4-year) outcomes of patients with unprotected left main coronary artery narrowing treated with drug-eluting stents versus coronary-artery bypass grafting. Am J Cardiol 105:1728-734 CrossRef
  36. Capodanno D, Stone GW, Morice MC, Bass TA (2011) Percutaneous coronary intervention versus coronary artery bypass graft surgery in left main coronary artery disease: a meta-analysis of randomized clinical data. J Am Coll Cardiol 58:1426-432 CrossRef
  37. Ferrante G, Presbitero P, Valgimigli M, Morice MC (2011) Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials. EuroIntervention 7:738-46, 731 CrossRef
  38. Naik H, White AJ, Chakravarty T, Forrester J (2009) A meta-analysis of 3,773 patients treated with percutaneous coronary intervention or surgery for unprotected left main coronary artery stenosis. JACC Cardiovasc Interv 2:739-47 CrossRef
  39. Takagi H, Kawai N, Umemoto T (2009) Stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: a meta-analysis of comparative studies. J Thorac Cardiovasc Surg 137:e54–e57 CrossRef
  40. Takagi H, Matsui M, Umemoto T (2010) Increased late mortality with percutaneous stenting for unprotected left main coronary artery stenosis relative to coronary artery bypass grafting: a meta-analysis of observational studies. J Thorac Cardiovasc Surg 139:1351-353 CrossRef
  41. Zheng S, Zheng Z, Hou J, Hu S (2011) Comparison between drug-eluting stents and coronary artery bypass grafting for unprotected left main coronary artery disease: a meta-analysis of two randomized trials and thirteen observational studies. Cardiology 118:22-2 CrossRef
  42. Mehilli J, Kastrati A, Byrne RA, Bruskina O (2009) Paclitaxel- versus sirolimus-eluting stents for unprotected left main coronary artery disease. J Am Coll Cardiol 53:1760-768 CrossRef
  43. Mohr FW, Rastan AJ, Serruys PW, Kappetein AP (2011) Complex coronary anatomy in coronary artery bypass graft surgery: impact of complex coronary anatomy in modern bypass surgery? Lessons learned from the Syntax trial after two years. J Thorac Cardiovasc Surg 141:130-40 CrossRef
  44. Morice MC, Serruys PW, Kappetein AP, Feldman TE (2010) Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the synergy between percutaneous coronary intervention with taxus and cardiac surgery (Syntax) trial. Circulation 121:2645-653 CrossRef
  45. Cohen DJ, Van Hout B, Serruys PW, Mohr FW (2011) Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery. N Engl J Med 364:1016-026 CrossRef
  46. Serruys PW, Morice MC, Kappetein AP, Colombo A (2009) Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 360:961-72 CrossRef
  
• 作者单位：PD Dr. S. Desch (1)
  E. Boudriot (1)
  A. Rastan (2)
  P.E. Buszman (3)
  A. Bochenek (4)
  F.W. Mohr (2)
  G. Schuler (1)
  H. Thiele (1)
  
  1. Department of Internal Medicine/Cardiology, University of Leipzig Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
  2. Department of Cardiac Surgery, University of Leipzig Heart Center, Leipzig, Germany
  3. Department of Cardiology, Medical University of Silesia, Katowice, Poland
  4. Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
  
• ISSN：1615-6692

文摘

Objective We performed a meta-analysis of randomized controlled trials to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for the treatment of de novo unprotected left main disease. Background Although CABG is accepted to be standard of care for revascularization of unprotected left main stenosis, PCI is increasingly being used as an alternative primary approach. Methods We searched for randomized, controlled trials comparing CABG and PCI for the treatment of unprotected left main disease. Major adverse cardiac and cerebrovascular events (all-cause death, myocardial infarction, stroke, and repeat revascularization) were analyzed. Results The search strategy identified 4 randomized controlled trials enrolling a total of 1,611 patients. Follow-up ranged between 1 and 2 years. There were no significant differences in the risk of death or myocardial infarction between the two treatment modalities. While the risk of stroke was significantly lower in patients undergoing PCI (risk ratio (RR) 0.26, 95% confidence interval (CI) 0.10-.69, p--.007), the risk of repeat revascularization was higher among patients undergoing PCI (RR 1.94, 95% CI 1.43-.61, p-lt;-.001). No relevant statistical heterogeneity across studies could be found. Conclusion In this largest series of randomized patients with unprotected left main stenosis to date, the risk of death and myocardial infarction was comparable between CABG and PCI. However, patients undergoing CABG had a higher risk of stroke, whereas patients undergoing PCI were at a higher risk for repeat revascularization.