Author + information
- Wina Yousmana,b,
- Justin Leea,b,
- Wei Xiang Wonga,b,
- Jarred Sargeanta,b,
- Carol Howea,b,
- Iwan Nyotowidjojoa,b,
- Ahmed Pashaa,b,
- David Fortuina,b and
- Kwan Leea,b
Background: The increase in life expectancy has led to increasingly higher numbers of coronary artery bypass grafts (CABG) and percutaneous coronary artery placement with drug-eluting stents (DES) being performed in elderly patients each year. We aim to compare the outcome of CABG and DES in elderly patients with unprotected left main (ULM) disease.
Methods: A systematic literature search of PubMed, EMBASE, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials yielded 5 eligible non-randomized registry studies comparing DES and CABG for the treatment of ULM disease in elderly patients (aged ≥ 70 years). In all studies, first generation drug eluting stents were used. In all CABG, left internal mammary vessels were used whenever possible. Primary outcome was two-year mortality.
Results: Data from 5 studies yielded a total of 1149 patients aged ≥ 70 years, with 527 treated with DES and 622 treated with CABG. The composite two-year mortality was 15.6% in DES-treated patients and 13.1% in CABG-treated patients (p=0.52). The incidence of two-year target lesion revascularization (TLR) was 19.4% in DES-treated patients and 4.1% in CABG-treated patients (p=0.004). Clinical characteristics and outcome data are displayed in the table below.
Conclusions: Elderly patients with ULM disease who undergo multi-vessel revascularization experienced similar mortality and myocardial infarction rates for CABG and DES placement to two years. However, the rate of TLR was higher in the DES group.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Complex Coronary Intervention: Left Main/Bifurcations and Multivessel Disease
Abstract Category: 22. Interventional Cardiology: Coronary Intervention: Left Main, Multivessel, Bifurcation
Presentation Number: 1157-194
- 2017 American College of Cardiology Foundation