Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY.
Duke Clinical Research Institute, Durham, NC.
Am Heart J. 2020 Sep;227:9-10. doi: 10.1016/j.ahj.2020.06.001. Epub 2020 Jun 7.
We aimed to investigate long-term (≥5 years) outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) using a meta-analysis from updated published randomized trials. Our data showed that the risk of all-cause death as well as cardiovascular death, myocardial infarction, and stroke was similar between PCI and CABG, whereas PCI had significantly higher rates of repeat revascularization compared to CABG. Decisions for PCI versus CABG for LMCAD should be based on weighing the upfront morbidity and mortality risk of CABG with late risk of repeat revascularization with PCI and taking into consideration patient preference.
我们旨在通过对已发表的随机试验进行更新的荟萃分析，研究经皮冠状动脉介入治疗（PCI）与冠状动脉旁路移植术（CABG）治疗左主干冠状动脉疾病（LMCAD）的长期（≥5 年）结果。我们的数据显示，PCI 与 CABG 之间全因死亡以及心血管死亡、心肌梗死和卒中等风险相似，而 PCI 的再次血运重建率明显高于 CABG。对于 LMCAD 的 PCI 与 CABG 决策应基于权衡 CABG 的 upfront 发病率和死亡率风险与 PCI 的再次血运重建风险，并考虑患者的偏好。
