左前下行枝領域に定量的冠動脈造影上有意狭窄病変をもつ虚血性心疾患に対する,冠動脈インターベンション,冠動脈バイパス術,薬物治療の短期および長期予後の比較検討

概要

論文の詳細を見る
Background : While coronary bare metal stenting (Stent) and bypass graft (CABG) are well-accepted treatments for left anterior descending coronary artery (LAD) lesions, long-term outcome has not been established as compared to medical therapy (MED). Methods : We prospectively performed quantitative coronary angiography (QCA) in patients with Stent, CABG, and MED having LAD disease. Three-year clinical outcome was compared among Stent, CABG and MED. Major adverse cardiac events (MACE) was defined as cardiac death, Q-wave myocardial infarction (MI), CABG, target lesion revascularization (TLR) and target lesion revascularization excluding hybrid therapy with PCI after CABG (TVR-ex-Hybrid). Results : MACE within eight months occurred more common in the Stent group; n=46 (26.6%) and the CABG group; n=19 (16.5%) than MED group; n=14 (6.6%) (p<0.0001). Most of MACE were included restenosis after PCI (86.9%) and revascularization after CABG (84.2%) in the within eight months. While three years, MACE was less common in the MED group than those in Stent and CABG : Stent group; n=55 (31.8%), CABG group; n=24 (20.9%), MED group; n=39 (18.4%) (p=0.0064), the majority of MACE in PCI and CABG was included restenosis after PCI (83.6%) or revascularization after CABG (70.8%). In three years, cardiac death was more common in the MED group; n=10 (4.7%) vs Stent group; n=1 (0.6%), CABG group; n=2 (1.7%) (p=0.0320). Conclusions : Three-year's MACE, which mostly included restenosis after PCI and revascularization after CABG, were significantly less in MED group than Stent and CABG groups. In contrast, cardiac death were more common in MED than Stent and CABG in this population, which provides a rationale that invasive treatment is warranted to improve long-term survival. While drug eluting stent may eliminate the restenosis, in the future the event-free survival of Stent theoretically can be similar to that of CABG. As MACE still tended to be higher in Stent than CABG, CABG to the LAD therefore would have still an advantage in some patients.
愛知医科大学の論文
2006-03-15

左前下行枝領域に定量的冠動脈造影上有意狭窄病変をもつ虚血性心疾患に対する,冠動脈インターベンション,冠動脈バイパス術,薬物治療の短期および長期予後の比較検討

スポンサーリンク

概要

著者

関連論文

スポンサーリンク