Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry

Duk Woo Park; Ki Bae Seung; Young Hak Kim; Jong Young Lee; Won Jang Kim; Soo Jin Kang; Seung Whan Lee; Cheol Whan Lee; Seong Wook Park; Sung Cheol Yun; Hyeon Cheol Gwon; Myung Ho Jeong; Yang Soo Jang; Hyo Soo Kim; Pum Joon Kim; In Whan Seong; Hun Sik Park; Taehoon Ahn; In Ho Chae; Seung Jea Tahk; Wook Sung Chung; Seung Jung Park

doi:10.1016/j.jacc.2010.04.004

Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry

Duk Woo Park, Ki Bae Seung, Young Hak Kim, Jong Young Lee, Won Jang Kim, Soo Jin Kang, Seung Whan Lee, Cheol Whan Lee, Seong Wook Park, Sung Cheol Yun, Hyeon Cheol Gwon, Myung Ho Jeong, Yang Soo Jang, Hyo Soo Kim, Pum Joon Kim, In Whan Seong, Hun Sik Park, Taehoon Ahn, In Ho Chae, Seung Jea TahkWook Sung Chung, Seung Jung Park

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

248 Citations (Scopus)

Abstract

Objectives: We performed the long-term follow-up of a large cohort of patients in a multicenter study receiving left main coronary artery (LMCA) revascularization. Background: Limited information is available on long-term outcomes for patients with unprotected LMCA disease who underwent coronary stent procedure or coronary artery bypass grafting (CABG). Methods: We evaluated 2,240 patients with unprotected LMCA disease who received coronary stents (n = 1,102; 318 with bare-metal stents and 784 with drug-eluting stents) or underwent CABG (n = 1,138) between 2000 and 2006 and for whom complete follow-up data were available for at least 3 to 9 years (median 5.2 years). The 5-year adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]) were compared with the use of the inverse probability of treatment weighted method and propensity-score matching. Results: After adjustment for differences in baseline risk factors with the inverse probability of treatment weighting, the 5-year risk of death (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 0.88 to 1.44, p = 0.35) and the combined risk of death, Q-wave MI, or stroke (HR: 1.07; 95% CI: 0.84 to 1.37, p = 0.59) were not significantly different for patients undergoing stenting versus CABG. The risk of TVR was significantly higher in the stenting group than in the CABG group (HR: 5.11; 95% CI: 3.52 to 7.42, p < 0.001). Similar results were obtained in comparisons of bare-metal stent with concurrent CABG and of drug-eluting stent with concurrent CABG. In further analysis with propensity-score matching, overall findings were consistent. Conclusions: During 5-year follow-up, stenting showed similar rates of mortality and of the composite of death, Q-wave MI, or stroke but higher rates of TVR as compared with CABG for patients with unprotected LMCA disease.

Original language	English
Pages (from-to)	117-124
Number of pages	8
Journal	Journal of the American College of Cardiology
Volume	56
Issue number	2
DOIs	https://doi.org/10.1016/j.jacc.2010.04.004
Publication status	Published - 2010 Jul 6

Bibliographical note

Funding Information:
Dr. Duk-Woo Park has received lecture fees from Cordis and Boston Scientific. Dr. Young-Hak Kim has received lecture fees from Cordis. Dr. Cheol Whan Lee has received lecture fees from Medtronic. Dr. Seng-Wook Park has received research support from Medtronic . Dr. Hyeon-Cheol Gwon has received lecture fees from Boston Scientific and Medtronic, and research grant support from Medtronic . Dr. Myung-Ho Jeong has received lecture fees from Cordis, Medtronic, and Boston Scientific. Dr. Hyo-Soo Kim has received consulting fees from Abbott Vascular. Dr. In-Whan Seong has received grant support from Boston Scientific . Dr. Seung-Jea Tahk has received lecture fees from Boston Scientific. Dr. Wook-Song Chung has received lecture fees from Cordis and Boston Scientific. Dr. Seung-Jung Park has received consulting fees from Cordis, lecture fees from Cordis, Medtronic, and Boston Scientific, and received research grant from Cordis and Medtronic .

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1016/j.jacc.2010.04.004

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Park, D. W., Seung, K. B., Kim, Y. H., Lee, J. Y., Kim, W. J., Kang, S. J., Lee, S. W., Lee, C. W., Park, S. W., Yun, S. C., Gwon, H. C., Jeong, M. H., Jang, Y. S., Kim, H. S., Kim, P. J., Seong, I. W., Park, H. S., Ahn, T., Chae, I. H., ... Park, S. J. (2010). Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry. Journal of the American College of Cardiology, 56(2), 117-124. https://doi.org/10.1016/j.jacc.2010.04.004

Park, Duk Woo ; Seung, Ki Bae ; Kim, Young Hak et al. / Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry. In: Journal of the American College of Cardiology. 2010 ; Vol. 56, No. 2. pp. 117-124.

@article{585617ca536c47fdab19a0c321ae7166,

title = "Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry",

abstract = "Objectives: We performed the long-term follow-up of a large cohort of patients in a multicenter study receiving left main coronary artery (LMCA) revascularization. Background: Limited information is available on long-term outcomes for patients with unprotected LMCA disease who underwent coronary stent procedure or coronary artery bypass grafting (CABG). Methods: We evaluated 2,240 patients with unprotected LMCA disease who received coronary stents (n = 1,102; 318 with bare-metal stents and 784 with drug-eluting stents) or underwent CABG (n = 1,138) between 2000 and 2006 and for whom complete follow-up data were available for at least 3 to 9 years (median 5.2 years). The 5-year adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]) were compared with the use of the inverse probability of treatment weighted method and propensity-score matching. Results: After adjustment for differences in baseline risk factors with the inverse probability of treatment weighting, the 5-year risk of death (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 0.88 to 1.44, p = 0.35) and the combined risk of death, Q-wave MI, or stroke (HR: 1.07; 95% CI: 0.84 to 1.37, p = 0.59) were not significantly different for patients undergoing stenting versus CABG. The risk of TVR was significantly higher in the stenting group than in the CABG group (HR: 5.11; 95% CI: 3.52 to 7.42, p < 0.001). Similar results were obtained in comparisons of bare-metal stent with concurrent CABG and of drug-eluting stent with concurrent CABG. In further analysis with propensity-score matching, overall findings were consistent. Conclusions: During 5-year follow-up, stenting showed similar rates of mortality and of the composite of death, Q-wave MI, or stroke but higher rates of TVR as compared with CABG for patients with unprotected LMCA disease.",

author = "Park, {Duk Woo} and Seung, {Ki Bae} and Kim, {Young Hak} and Lee, {Jong Young} and Kim, {Won Jang} and Kang, {Soo Jin} and Lee, {Seung Whan} and Lee, {Cheol Whan} and Park, {Seong Wook} and Yun, {Sung Cheol} and Gwon, {Hyeon Cheol} and Jeong, {Myung Ho} and Jang, {Yang Soo} and Kim, {Hyo Soo} and Kim, {Pum Joon} and Seong, {In Whan} and Park, {Hun Sik} and Taehoon Ahn and Chae, {In Ho} and Tahk, {Seung Jea} and Chung, {Wook Sung} and Park, {Seung Jung}",

note = "Funding Information: Dr. Duk-Woo Park has received lecture fees from Cordis and Boston Scientific. Dr. Young-Hak Kim has received lecture fees from Cordis. Dr. Cheol Whan Lee has received lecture fees from Medtronic. Dr. Seng-Wook Park has received research support from Medtronic . Dr. Hyeon-Cheol Gwon has received lecture fees from Boston Scientific and Medtronic, and research grant support from Medtronic . Dr. Myung-Ho Jeong has received lecture fees from Cordis, Medtronic, and Boston Scientific. Dr. Hyo-Soo Kim has received consulting fees from Abbott Vascular. Dr. In-Whan Seong has received grant support from Boston Scientific . Dr. Seung-Jea Tahk has received lecture fees from Boston Scientific. Dr. Wook-Song Chung has received lecture fees from Cordis and Boston Scientific. Dr. Seung-Jung Park has received consulting fees from Cordis, lecture fees from Cordis, Medtronic, and Boston Scientific, and received research grant from Cordis and Medtronic . ",

year = "2010",

month = jul,

day = "6",

doi = "10.1016/j.jacc.2010.04.004",

language = "English",

volume = "56",

pages = "117--124",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier USA",

number = "2",

}

Park, DW, Seung, KB, Kim, YH, Lee, JY, Kim, WJ, Kang, SJ, Lee, SW, Lee, CW, Park, SW, Yun, SC, Gwon, HC, Jeong, MH, Jang, YS, Kim, HS, Kim, PJ, Seong, IW, Park, HS, Ahn, T, Chae, IH, Tahk, SJ, Chung, WS & Park, SJ 2010, 'Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry', Journal of the American College of Cardiology, vol. 56, no. 2, pp. 117-124. https://doi.org/10.1016/j.jacc.2010.04.004

Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry. / Park, Duk Woo; Seung, Ki Bae; Kim, Young Hak et al.

In: Journal of the American College of Cardiology, Vol. 56, No. 2, 06.07.2010, p. 117-124.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Long-Term Safety and Efficacy of Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. 5-Year Results From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry

AU - Park, Duk Woo

AU - Seung, Ki Bae

AU - Kim, Young Hak

AU - Lee, Jong Young

AU - Kim, Won Jang

AU - Kang, Soo Jin

AU - Lee, Seung Whan

AU - Lee, Cheol Whan

AU - Park, Seong Wook

AU - Yun, Sung Cheol

AU - Gwon, Hyeon Cheol

AU - Jeong, Myung Ho

AU - Jang, Yang Soo

AU - Kim, Hyo Soo

AU - Kim, Pum Joon

AU - Seong, In Whan

AU - Park, Hun Sik

AU - Ahn, Taehoon

AU - Chae, In Ho

AU - Tahk, Seung Jea

AU - Chung, Wook Sung

AU - Park, Seung Jung

N1 - Funding Information: Dr. Duk-Woo Park has received lecture fees from Cordis and Boston Scientific. Dr. Young-Hak Kim has received lecture fees from Cordis. Dr. Cheol Whan Lee has received lecture fees from Medtronic. Dr. Seng-Wook Park has received research support from Medtronic . Dr. Hyeon-Cheol Gwon has received lecture fees from Boston Scientific and Medtronic, and research grant support from Medtronic . Dr. Myung-Ho Jeong has received lecture fees from Cordis, Medtronic, and Boston Scientific. Dr. Hyo-Soo Kim has received consulting fees from Abbott Vascular. Dr. In-Whan Seong has received grant support from Boston Scientific . Dr. Seung-Jea Tahk has received lecture fees from Boston Scientific. Dr. Wook-Song Chung has received lecture fees from Cordis and Boston Scientific. Dr. Seung-Jung Park has received consulting fees from Cordis, lecture fees from Cordis, Medtronic, and Boston Scientific, and received research grant from Cordis and Medtronic .

PY - 2010/7/6

Y1 - 2010/7/6

N2 - Objectives: We performed the long-term follow-up of a large cohort of patients in a multicenter study receiving left main coronary artery (LMCA) revascularization. Background: Limited information is available on long-term outcomes for patients with unprotected LMCA disease who underwent coronary stent procedure or coronary artery bypass grafting (CABG). Methods: We evaluated 2,240 patients with unprotected LMCA disease who received coronary stents (n = 1,102; 318 with bare-metal stents and 784 with drug-eluting stents) or underwent CABG (n = 1,138) between 2000 and 2006 and for whom complete follow-up data were available for at least 3 to 9 years (median 5.2 years). The 5-year adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]) were compared with the use of the inverse probability of treatment weighted method and propensity-score matching. Results: After adjustment for differences in baseline risk factors with the inverse probability of treatment weighting, the 5-year risk of death (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 0.88 to 1.44, p = 0.35) and the combined risk of death, Q-wave MI, or stroke (HR: 1.07; 95% CI: 0.84 to 1.37, p = 0.59) were not significantly different for patients undergoing stenting versus CABG. The risk of TVR was significantly higher in the stenting group than in the CABG group (HR: 5.11; 95% CI: 3.52 to 7.42, p < 0.001). Similar results were obtained in comparisons of bare-metal stent with concurrent CABG and of drug-eluting stent with concurrent CABG. In further analysis with propensity-score matching, overall findings were consistent. Conclusions: During 5-year follow-up, stenting showed similar rates of mortality and of the composite of death, Q-wave MI, or stroke but higher rates of TVR as compared with CABG for patients with unprotected LMCA disease.

AB - Objectives: We performed the long-term follow-up of a large cohort of patients in a multicenter study receiving left main coronary artery (LMCA) revascularization. Background: Limited information is available on long-term outcomes for patients with unprotected LMCA disease who underwent coronary stent procedure or coronary artery bypass grafting (CABG). Methods: We evaluated 2,240 patients with unprotected LMCA disease who received coronary stents (n = 1,102; 318 with bare-metal stents and 784 with drug-eluting stents) or underwent CABG (n = 1,138) between 2000 and 2006 and for whom complete follow-up data were available for at least 3 to 9 years (median 5.2 years). The 5-year adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]) were compared with the use of the inverse probability of treatment weighted method and propensity-score matching. Results: After adjustment for differences in baseline risk factors with the inverse probability of treatment weighting, the 5-year risk of death (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 0.88 to 1.44, p = 0.35) and the combined risk of death, Q-wave MI, or stroke (HR: 1.07; 95% CI: 0.84 to 1.37, p = 0.59) were not significantly different for patients undergoing stenting versus CABG. The risk of TVR was significantly higher in the stenting group than in the CABG group (HR: 5.11; 95% CI: 3.52 to 7.42, p < 0.001). Similar results were obtained in comparisons of bare-metal stent with concurrent CABG and of drug-eluting stent with concurrent CABG. In further analysis with propensity-score matching, overall findings were consistent. Conclusions: During 5-year follow-up, stenting showed similar rates of mortality and of the composite of death, Q-wave MI, or stroke but higher rates of TVR as compared with CABG for patients with unprotected LMCA disease.

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