Percutaneous Coronary Intervention With Drug-Eluting Stent Implantation vs. Coronary Artery Bypass Grafting for Multivessel Coronary Artery Disease in Metabolic Syndrome Patients With Acute Myocardial Infarction

Title
Percutaneous Coronary Intervention With Drug-Eluting Stent Implantation vs. Coronary Artery Bypass Grafting for Multivessel Coronary Artery Disease in Metabolic Syndrome Patients With Acute Myocardial Infarction
Author(s)
김영조정명호[정명호]홍영준[홍영준]심두선[심두선]황승환[황승환]이민구[이민구]박근호[박근호]김주한[김주한]안영근[안영근]Rabin Chakraborty[Rabin Chakraborty]조명찬[조명찬]김총진[김총진]박종천[박종천]강정채[강정채]Khurshid Ahmed[Khurshid Ahmed]
Keywords
CARDIOVASCULAR RISK; DIABETES-MELLITUS; SURGERY; METAANALYSIS; CONTROVERSY; DIAGNOSIS; TRIALS; SAFETY; PCI
Issue Date
201203
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.76, no.3, pp.721 - 728
Abstract
Background: Coronary artery bypass grafting (CABG) has been the treatment of choice for management of multivessel coronary artery disease, but percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is increasingly being preferred. The aim of the present study was to compare outcomes of PCI with DES implantation (PCI-DES) and CABG for treating multivessel disease in metabolic syndrome patients with acute myocardial infarction (AMI). Methods and Results: A total 01 1,839 consecutive metabolic syndrome patients with AMI who underwent PCI-DES (n=1,715) and CABG (n=124) for treatment of multivessel disease were selected from Korea Acute Myocardial Infarction Registry from November 2005 through December 2006. Primary endpoint was 12-month all-cause mortality. The mortality rate at 12 months was significantly lower in the PCI-DES group (4.8% vs. 12.2% in CABG, P=0.014) on univariate analysis. According to a Cox model, 12-month mortality was similar between the 2 groups (P=0.603), which remained the same despite propensity score adjustment (P=0.485). Rate of repeat revascularization was significantly higher in the PCI-DES group compared to the CABG group (P<0.001). At 12 months, major adverse cardiovascular and cerebrovascular event (MACCE)-free survival was higher in ST-elevation MI (STEMI) patients in the CABG group. Conclusions: PCI-DES had an equivalent 12-month mortality risk to CABG for the treatment of multivessel disease in metabolic syndrome patients with AMI. CABG is more favorable for STEMI patients in terms of MACCE. (Circ J 2012; 76: 721-728)
URI
http://hdl.handle.net/YU.REPOSITORY/29657http://dx.doi.org/10.1253/circj.CJ-11-1013
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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