Long-term results of stenting versus coronary artery bypass surgery for left main coronary artery disease—A single-center experience

摘要

Background: Percutaneous coronary intervention (PCI) has emerged as an alternative treatment to coronary artery bypass grafting (CABG) for unprotected left main (LM) coronary artery disease, but the results of both treatments are less clear in real-world practice. We aimed to assess the long-term outcomes of unprotected LM disease treated with CABG or PCI with stenting in high-risk population from a single center. Methods: We collected 478 consecutive patients with unprotected LM disease (PCI/CABG: 208/270; mean age: 70?±?11?years; 85% male), and 252 patients were considered to be at high risk (European System for Cardiac Operative Risk Evaluation ≥6). The median follow-up was 4.3?years (interquartile range: 2.7–6.5?years). Results: All-cause death (PCI/CABG: 27.4%/31.5%; p?=?0.36) and all-cause death/myocardial infarction (MI)/stroke (PCI/CABG: 30.8%/35.9%; p?=?0.49) were comparable between the two groups, whereas the repeat revascularization rate was significantly higher in the PCI group (PCI/CABG: 22.6%/11.0%; p?