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Differential Event Rates and Independent Predictors of Long-Term Major Cardiovascular Events and Death in 5795 Patients With Unprotected Left Main Coronary Artery Disease Treated With Stents, Bypass Surgery, or Medication
- Source :
- Circulation: Cardiovascular Interventions. 10
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Background— Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. Methods and Results— The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608). We analyzed the incidence and independent predictors of major adverse cardiac and cerebrovascular events (MACCE; a composite of death, MI, stroke, or repeat revascularization) and all-cause mortality in each treatment stratum. During follow-up (median, 4.3 years), the rates of MACCE and death were substantially higher in the medical group than in the percutaneous coronary intervention and coronary-artery bypass grafting groups ( P Conclusions— Among patients with unprotected left main coronary artery disease, the key clinical predictors for MACCE and death were generally similar regardless of index treatment. This study provides effect estimates for clinically relevant predictors of long-term clinical outcomes in real-world left main coronary artery patients, providing possible guidance for tailored preventive strategies. Clinical Trial Registration— URL: https://clinicaltrials.gov . Unique identifier: NCT01341327.
- Subjects :
- Male
medicine.medical_specialty
Asia
Time Factors
medicine.medical_treatment
Myocardial Infarction
Comorbidity
Coronary Artery Disease
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
Coronary artery bypass surgery
Percutaneous Coronary Intervention
0302 clinical medicine
Risk Factors
Cause of Death
Internal medicine
medicine
Humans
In patient
Registries
030212 general & internal medicine
Coronary Artery Bypass
Left main coronary artery disease
Stroke
Aged
Proportional Hazards Models
business.industry
Percutaneous coronary intervention
Cardiovascular Agents
Middle Aged
medicine.disease
Treatment Outcome
Bypass surgery
Heart failure
Clinical value
Cardiology
Female
Stents
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 19417632 and 19417640
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....ba2b94021231268d07110539ae202952