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Stachon, P; Kaier, K; Hehn, P; Peikert, A; Wolf, D; Oettinger, V; Staudacher, D; Duerschmied, D; Zirlik, A; Zehender, M; Bode, C; von, Zur, Mühlen, C.
Coronary artery bypass grafting versus stent implantation in patients with chronic coronary syndrome and left main disease: insights from a register throughout Germany.
Clin Res Cardiol. 2022; 111(7):742-749 Doi: 10.1007/s00392-021-01931-x [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Peikert Alexander
Zirlik Andreas
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Abstract:
BACKGROUND: Recent randomized controlled trials have sparked debate about the optimal treatment of patients suffering from left main coronary artery disease. The present study analyzes outcomes of left main stenting versus coronary bypass grafting (CABG) in a nationwide registry in patients with chronic coronary syndrome (CCS). METHODS: All cases suffering from CCS and left main coronary artery disease treated either with CABG or stent, were identified within the database of the German bureau of statistics. Logistic or linear regression models were used with 20 baseline patient characteristics as potential confounders to compare both regimens. RESULTS: In 2018, 1318 cases with left main stenosis were treated with CABG and 8,920 with stent. Patients assigned for stenting were older (72.58 ± 9.87 vs. 68.63 ± 9.40, p < 0.001) and at higher operative risk, as assessed by logistic EuroSCORE (8.77 ± 8.45 vs. 4.85 ± 4.65, p < 0.001). After risk adjustment, no marked differences in outcomes were found for in-hospital mortality and stroke (risk adjusted odds ratio (aOR) for stent instead of CABG: aOR mortality: 1.08 [95% CI 0.66; 1.78], p = 0.748; aOR stroke: 0.59 [0.27; 1.32], p = 0.199). Stent implantation was associated with a reduced risk of relevant bleeding (aOR 0.38 [0.24; 0.61], p < 0.001), reduced prolonged ventilation time (aOR 0.54 [0.37 0.79], p = 0.002), and postoperative delirium (aOR 0.16 [0.11; 0.22], p < 0.001). Furthermore, stent implantation was associated with shorter hospital stay (- 6.78 days [- 5.86; - 7.71], p < 0.001) and lower costs (- €10,035 [- €11,500; - €8570], p < 0.001). CONCLUSION: Left main stenting is a safe and effective treatment option for CCS-patients suffering from left main coronary artery disease at reasonable economic cost. Coronary artery bypass grafting versus stent implantation in patients with chronic coronary syndrome and left main disease: insights from a register throughout Germany. All cases with chronic coronary syndrome and left main stenosis treated in 2018 in Germany either with left main stenting or coronary bypass grafting were extracted from a nation-wide database. In-hospital outcomes were compared after logistic regression analysis.
Find related publications in this database (using NLM MeSH Indexing)
Constriction, Pathologic - etiology
Coronary Artery Bypass - adverse effects
Coronary Artery Disease - diagnosis, surgery
Drug-Eluting Stents - adverse effects
Germany - epidemiology
Humans - administration & dosage
Percutaneous Coronary Intervention - adverse effects
Stents - administration & dosage
Stroke - etiology
Treatment Outcome - administration & dosage

Find related publications in this database (Keywords)
Left main coronary artery disease
Stent
Coronary artery bypass grafting
mortality
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