Temporal Trends in Revascularization Strategy and Outcomes in Left Main Coronary Artery Stenosis

DOI Web Site 被引用文献2件
  • Seung-Jung Park
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Jung-Min Ahn
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Young-Hak Kim
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Duk-Woo Park
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Sung-Cheol Yun
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Sung-Han Yoon
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Hyun Woo Park
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Mineok Chang
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Jong-Young Lee
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Soo-Jin Kang
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Seung-Whan Lee
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Cheol Whan Lee
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  • Seong-Wook Park
    From the Heart Institute (S.-J.P., J.-M.A., Y.-H.K., D.-W.P., S.-H.Y., H.W.P., M.C., J.-Y.L., S.-J.K., S.-W.L., C.W.L., S.-W.P.) and Division of Biostatistics (S.-C.Y.), Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.

書誌事項

タイトル別名
  • Data From the Asan Medical Center-Left Main Revascularization Registry

説明

<jats:sec> <jats:title>Background—</jats:title> <jats:p>Changes over time in revascularization strategies and outcomes among patients with unprotected left main coronary artery stenosis remain largely unknown.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> A total of 2618 consecutive patients with unprotected left main coronary artery stenosis who underwent revascularization were identified from the ASAN Medical Center-Left MAIN Revascularization registry and classified by time periods: bare metal stent (wave 1, 1995–1998), early drug-eluting stents (wave 2, 2003–2006), and late drug-eluting stents (wave 3, 2007–2010). Primary end point was major adverse cerebrocardiovascular events (the composite of death, myocardial infarction, repeat revascularization, and stroke). During the study period, 1124 patients underwent percutaneous coronary intervention (PCI) and 1494 patients underwent coronary artery bypass grafting. The proportion of PCI significantly increased from 35% to 52% between waves 1 and 3. In patients receiving PCI, the risk-adjusted incidence rate of major adverse cerebro-cardiovascular events decreased from 20.18 cases per 100 person-years in wave 1 to 6.77 cases per 100 person-years in wave 3 ( <jats:italic>P</jats:italic> <0.001 for trend). Death, the composite of death, myocardial infarction, stroke, and repeat revascularization were also significantly decreased by 40%, 35%, and 46%, respectively. The risk-adjusted incidence rate of major adverse cerebrocardiovascular events did not change in patients receiving coronary artery bypass grafting. The difference major adverse cerebrocardiovascular events risk between PCI and coronary artery bypass grafting progressively reduced (adjusted hazard ratio [95% confidence interval], 0.33 [0.23–0.47]; 0.53 [0.35–0.80]; and 1.01 [0.68–1.49] from wave 1 to wave 3. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>The outcomes of unprotected left main coronary artery PCI have significantly improved over time. In addition, more patients received PCI for unprotected left main coronary artery stenosis in recent years.</jats:p> </jats:sec>

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