Trial of everolimus-eluting stents or bypass surgery for coronary disease

The New England Journal of Medicine
Seung-Jung ParkBEST Trial Investigators

Abstract

Most trials comparing percutaneous coronary intervention (PCI) with coronary-artery bypass grafting (CABG) have not made use of second-generation drug-eluting stents. We conducted a randomized noninferiority trial at 27 centers in East Asia. We planned to randomly assign 1776 patients with multivessel coronary artery disease to PCI with everolimus-eluting stents or to CABG. The primary end point was a composite of death, myocardial infarction, or target-vessel revascularization at 2 years after randomization. Event rates during longer-term follow-up were also compared between groups. After the enrollment of 880 patients (438 patients randomly assigned to the PCI group and 442 randomly assigned to the CABG group), the study was terminated early owing to slow enrollment. At 2 years, the primary end point had occurred in 11.0% of the patients in the PCI group and in 7.9% of those in the CABG group (absolute risk difference, 3.1 percentage points; 95% confidence interval [CI], -0.8 to 6.9; P=0.32 for noninferiority). At longer-term follow-up (median, 4.6 years), the primary end point had occurred in 15.3% of the patients in the PCI group and in 10.6% of those in the CABG group (hazard ratio, 1.47; 95% CI, 1.01 to 2.13; P=0.04). No ...Continue Reading

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Citations

Feb 13, 2016·Journal of Interventional Cardiology·Cindy L GrinesTheodore L Schreiber
Jan 26, 2016·The Journal of Thoracic and Cardiovascular Surgery·Filip CasselmanEmanuele Barbato
Jan 5, 2016·European Heart Journal·Philippe Gabriel StegWilliam Wijns
Sep 13, 2015·Progress in Cardiovascular Diseases·Gill Louise BuchananAntonio Colombo
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Mar 8, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Carlos HaiekAlfredo E Rodriguez
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May 23, 2015·Journal of the American College of Cardiology·Joseph F Sabik, Gregg W Stone
Jul 27, 2015·The American Journal of Cardiology·Peter JüniStephan Windecker
Sep 4, 2015·Lancet·Raffaele PiccoloStephan Windecker
Aug 6, 2015·The New England Journal of Medicine·Seung-Jung Park, Jung-Min Ahn
Apr 5, 2016·Expert Review of Cardiovascular Therapy·Michael O Kayatta, Michael E Halkos
May 18, 2016·The American Journal of Cardiology·Mineok ChangSeung-Jung Park
May 19, 2016·The New England Journal of Medicine·John H Alexander, Peter K Smith
Oct 19, 2016·The Journal of Thoracic and Cardiovascular Surgery·Michael MackBruce Lytle
Jun 28, 2016·International Journal of Cardiology·Umberto BenedettoGianni D Angelini
Jul 2, 2016·Journal of the American College of Cardiology·Farouc A Jaffer, Patrick T O'Gara
Jul 1, 2016·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Torsten DoenstGloria Faerber
Jul 9, 2016·Journal of the American College of Cardiology·Jung-Min AhnSeung-Jung Park
Aug 6, 2016·JACC. Cardiovascular Interventions·John W Hirshfeld, Matthew D Saybolt
Sep 3, 2016·Journal of the American College of Cardiology·G B John ManciniValentin Fuster
Sep 3, 2016·Journal of the American College of Cardiology·Stephan Windecker, Raffaele Piccolo
Sep 24, 2016·Interactive Cardiovascular and Thoracic Surgery·Michel KindoJean-Philippe Mazzucotelli
Jan 28, 2017·Journal of the American College of Cardiology·Patrick W Serruys, Vasim Farooq
Feb 7, 2017·Journal of the American Geriatrics Society·Mineok ChangSeung-Jung Park
Jan 26, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Kyohei YamajiStephan Windecker
Jan 1, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mineok ChangSeung-Jung Park
Mar 30, 2017·Annals of Surgery·Benjamin Speich
Jun 9, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Chaim LockerAmir Lerman
Jan 24, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Mineok ChangSeung-Jung Park
Apr 12, 2017·Diabetology & Metabolic Syndrome·Anna MarcinkiewiczJózef Drzewoski
Jul 19, 2015·Angiology·Thomas F Whayne
Feb 13, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Sung-Jin HongYangsoo Jang
Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Miguel Sousa-UvaUlf Landmesser
Apr 15, 2018·Nature Reviews. Cardiology·Demosthenes G KatritsisBernard J Gersh
Jul 12, 2018·Current Opinion in Cardiology·Lucas Colombo GodoyMichael E Farkouh
Mar 20, 2018·The Korean Journal of Internal Medicine·Yun-Kyeong Cho, Chang-Wook Nam

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