Comparison of Percutaneous Coronary Intervention With Coronary Artery Bypass Grafting in Unprotected Left Main Coronary Artery Disease – 5-Year Outcome From CREDO-Kyoto PCI/CABG Registry Cohort-2 –
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- Shiomi Hiroki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Morimoto Takeshi
- Department of Clinical Epidemiology, Hyogo College of Medicine
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- Furukawa Yutaka
- Division of Cardiology, Kobe City Medical Center General Hospital
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- Nakagawa Yoshihisa
- Division of Cardiology, Tenri Hospital
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- Sakata Ryuzo
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University
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- Okabayashi Hitoshi
- Department of Cardiovascular Surgery, Iwate Medical University
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- Hanyu Michiya
- Division of Cardiovascular Surgery, Kokura Memorial Hospital
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- Shimamoto Mitsuomi
- Division of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital
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- Nishiwaki Noboru
- Division of Cardiovascular Surgery, Nara Hospital, Kinki University Faculty of Medicine
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- Komiya Tatsuhiko
- Division of Cardiovascular Surgery, Kurashiki Central Hospital
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- Kimura Takeshi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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Background:Studies evaluating long-term (≥5 years) outcome of percutaneous coronary intervention (PCI) compared with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease (ULMCAD) are still limited, despite concerns for late adverse events after drug-eluting stents implantation.Methods and Results:We identified 1,004 patients with ULMCAD (PCI: n=364, CABG: n=640) among 15,939 patients with first coronary revascularization enrolled in the CREDO-Kyoto PCI/CABG registry cohort-2. The primary outcome measure in the current analysis was a composite of death, myocardial infarction, and stroke (death/MI/stroke). The cumulative 5-year incidence of and the adjusted risk for death/MI/stroke were significantly higher in the PCI group than in the CABG group (34.5% vs. 24.1%, log-rank P<0.001, adjusted hazard ratio (HR): 1.48 [95% confidence interval (CI): 1.07–2.05, P=0.02]). The adjusted risks for all-cause death was not significantly different between the 2 groups. Regarding the stratified analysis by the SYNTAX score, the adjusted risk for death/MI/stroke was not significantly different between the 2 groups in patients with low (<23) or intermediate (23–33) SYNTAX score, whereas it was significantly higher in the PCI group than in the CABG group in patients with high (≤33) SYNTAX score.Conclusions:CABG as compared with PCI was associated with better long-term outcome in patients with ULMCAD, especially those with high anatomical complexity. (Circ J 2015; 79: 1282–1289)
収録刊行物
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- Circulation Journal
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Circulation Journal 79 (6), 1282-1289, 2015
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390001205106281600
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- NII論文ID
- 130005073160
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 026398818
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- PubMed
- 25818902
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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