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Long-Term Effects Similar With CABG, Stents in LMCA Disease

But revascularization rate higher with stenting in unprotected left main coronary artery disease

THURSDAY, May 6 (HealthDay News) -- The rate of long-term adverse outcomes is similar in patients with unprotected left main coronary artery (LMCA) disease who undergo stenting or coronary artery bypass grafting (CABG), although those who undergo stenting have higher rates of target vessel revascularization, according to research published online May 5 in the Journal of the American College of Cardiology.

Duk-Woo Park, M.D., of the University of Ulsan College of Medicine in Seoul, South Korea, and colleagues evaluated 2,240 patients with unprotected LMCA disease who either received coronary stents (318 with bare metal stents and 784 with drug-eluting stents) or underwent CABG to compare the two treatments' long-term adverse outcomes.

The researchers found that the five-year risk of death and the combined risk of death, Q-wave myocardial infarction or stroke were not significantly different between patients receiving stents or those undergoing CABG. However, those in the stenting group had a significantly higher risk of target vessel revascularization (hazard ratio, 5.11). Results were similar for both bare-metal stents and drug-eluting stents with concurrent CABG.

"A large randomized comparison study with CABG will provide more confidence in the long-term safety, durability, and efficacy of percutaneous coronary intervention with drug-eluting stents," the authors write.

Several study authors disclosed financial ties to medical device companies.

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