Randomized Trial of Stents Versus Bypass Surgery for Left Main Coronary Artery Disease: 5-Year Outcomes of the PRECOMBAT Study

Journal of the American College of Cardiology
Jung-Min AhnSeung Jung Park

Abstract

In a previous randomized trial, we found that percutaneous coronary intervention (PCI) was not inferior to coronary artery bypass grafting (CABG) for the treatment of unprotected left main coronary artery stenosis at 1 year. This study sought to determine the 5-year outcomes of PCI compared with CABG for the treatment of unprotected left main coronary artery stenosis. We randomly assigned 600 patients with unprotected left main coronary artery stenosis to undergo PCI with a sirolimus-eluting stent (n = 300) or CABG (n = 300). The primary endpoint was a major adverse cardiac or cerebrovascular event (MACCE: a composite of death from any cause, myocardial infarction, stroke, or ischemia-driven target vessel revascularization) and compared on an intention-to-treat basis. At 5 years, MACCE occurred in 52 patients in the PCI group and 42 patients in the CABG group (cumulative event rates of 17.5% and 14.3%, respectively; hazard ratio [HR]: 1.27; 95% confidence interval [CI]: 0.84 to 1.90; p = 0.26). The 2 groups did not differ significantly in terms of death from any cause, myocardial infarction, or stroke as well as their composite (8.4% and 9.6%; HR, 0.89; 95% CI, 0.52 to 1.52; p = 0.66). Ischemia-driven target vessel revasculariz...Continue Reading

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Citations

Jul 15, 2015·Expert Review of Cardiovascular Therapy·Pil Hyung LeeSeung-Jung Park
Apr 5, 2016·Expert Review of Cardiovascular Therapy·Michael O Kayatta, Michael E Halkos
Jun 3, 2015·Journal of Cardiovascular Translational Research·Angela M Taylor, Michael Ragosta
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Oct 11, 2016·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Ana-Catarina Pinho-Gomes, David P Taggart
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Sep 10, 2016·Journal of the American College of Cardiology·Pil Hyung LeeSeung-Jung Park
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