Outcomes of patients with left main coronary artery disease undergoing medical or surgical treatment: a propensity- matched analysis

dc.contributor.authorDe Lorenzo, Andrea
dc.contributor.authorTura, Bernardo
dc.contributor.authorBassan, Fernando
dc.contributor.authorPittella, Felipe
dc.contributor.authorRocha, Antonio Sergio C
dc.description.abstractObjective: To evaluate the outcomes of patients with significant (≥ 50%) left main coronary artery disease (LMCAD) undergoing medical treatment (MT) or coronary artery bypass grafting surgery (CABG). Methods: A total of 181 patients with significant LMCAD were followed for 4 ± 2 years. MT was done when patients refused CABG or because of either thin native vessels or high clinical risk. Events were defined as all-cause death, myocardial infarction, percutaneous coronary intervention, or subsequent CABG. Logistic regression analysis was used to identify independent predictors of death. A propensity score was created to compare outcomes of patients from the two treatment groups. Results: CABG was performed in 78.5% of the patients. Overall, there were no significant differences in the incidences of death or other events between treatment groups. In patients with normal left ventricular (LV) function (ejection fraction, ≥ 45%), there were no significant differences in event rates with MT or CABG (death, 7.7 vs. 12.1%; myocardial infarction, 0 vs. 1.9%; percutaneous coronary intervention, 3.8 vs. 5.6%). For patients with LV dysfunction, death was more frequent with MT than with CABG (53.8 vs. 22.9%, P<0.001), whereas the incidence of other events was not statistically different. Age and LV dysfunction, but not treatment type, were independent predictors of death. When comparing propensity-matched patients from both treatment groups, there was also no difference in survival. Conclusion: Patients with 50% or more LMCAD and LV dysfunction had increased survival with CABG. However, outcomes of patients with 50% or more LMCAD and normal LV function were not significantly different with either MT or CABG.
dc.identifier.citationDe Lorenzo A, Tura B, Bassan F, Pittella F, Rocha AS. Outcomes of patients with left main coronary artery disease undergoing medical or surgical treatment: a propensity-matched analysis. Coron Artery Dis. 2011 Dec;22(8):585-9. doi: 10.1097/MCA.0b013e32834c7501.
dc.identifier.otherDOI: 10.1097/MCA.0b013e32834c7501
dc.publisherCoronary Artery Disease
dc.subject.meshVentricular Function, Leften
dc.subject.meshVentricular Dysfunction, Left / physiopathologyen
dc.subject.meshVentricular Dysfunction, Left / mortalityen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTime Factorsen
dc.subject.meshSeverity of Illness Indexen
dc.subject.meshRisk Factorsen
dc.subject.meshRisk Assessmenten
dc.subject.meshRetrospective Studiesen
dc.subject.meshPropensity Scoreen
dc.subject.meshMyocardial Infarction / etiologyen
dc.subject.meshMiddle Ageden
dc.subject.meshMatched-Pair Analysisen
dc.subject.meshLogistic Modelsen
dc.subject.meshKaplan-Meier Estimateen
dc.subject.meshCoronary Stenosis / therapyen
dc.subject.meshCoronary Stenosis / surgeryen
dc.subject.meshCoronary Stenosis / physiopathologyen
dc.subject.meshCoronary Stenosis / mortalityen
dc.subject.meshCoronary Artery Bypass / mortalityen
dc.subject.meshCoronary Artery Bypass / adverse effectsen
dc.subject.meshChi-Square Distributionen
dc.subject.meshAngioplasty, Balloon, Coronary / mortalityen
dc.subject.meshAngioplasty, Balloon, Coronary / adverse effectsen
dc.subject.meshAge Factorsen
dc.titleOutcomes of patients with left main coronary artery disease undergoing medical or surgical treatment: a propensity- matched analysis
Original bundle
Agora exibindo 1 - 1 de 1
Lorenzo A et al_Coron Artery Dis.pdf
136.54 KB
Adobe Portable Document Format
License bundle
Agora exibindo 1 - 1 de 1
1.71 KB
Item-specific license agreed to upon submission