Journal article
Revascularization for Isolated Proximal Left Anterior Descending Artery Disease
The Annals of thoracic surgery, v 112(2), pp 555-562
Aug 2021
PMID: 33144114
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Most studies of patients with isolated proximal left anterior descending (PLAD) coronary artery disease do not include all 3 procedural options: percutaneous coronary intervention (PCI), conventional coronary artery bypass graft (CABG) surgery, or minimally invasive CABG.
New York’s cardiac registries were used to identify patients who underwent revascularization for isolated PLAD disease between January 1, 2010, and November 30, 2016, in New York State. After exclusions, 14,327 patients, of whom 13,115 received PCI, 1001 of whom underwent CABG surgery, and 211 of whom underwent minimally invasive CABG were monitored through the end of 2017 to compare outcomes. Registry data were matched to vital statistics data to obtain deaths occurring after discharge and matched to claims data to obtain subsequent admissions for myocardial infarction and stroke.
There were no significant differences in mortality or in mortality/myocardial infarction/stroke after 7 years (with median follow-up times in excess of 4 years) among the 3 procedures after adjusting for differences in patient risk factors. However, conventional CABG surgery was associated with a lower subsequent revascularization rate than PCI (adjusted hazard ratio, 0.45; 95% confidence interval, 0.35-0.58) and minimally invasive CABG surgery (adjusted hazard ratio, 0.46; 95% confidence interval, 0.32-0.66).
Among patients with isolated PLAD disease undergoing any of 3 revascularization options (PCI, conventional CABG surgery, or minimally invasive CABG surgery), conventional CABG surgery was associated with lower subsequent revascularization rates, but there were no differences in mortality or mortality/myocardial infarction/stroke rates.
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Details
- Title
- Revascularization for Isolated Proximal Left Anterior Descending Artery Disease
- Creators
- Edward L. Hannan - School of Public Health, University at Albany, State University of New York, Albany, New YorkYe Zhong - University at Albany, State University of New YorkKimberly Cozzens - School of Public Health, University at Albany, State University of New York, Albany, New YorkDavid H. Adams - Mount Sinai HospitalLeonard Girardi - Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York, New York.Joanna Chikwe - Cedars-Sinai Medical CenterAndrew Wechsler - Drexel UniversityThoralf M. Sundt - Massachusetts General HospitalCraig R. Smith - Department of Surgery, Columbia-Presbyterian Irving Medical Center, New York, New YorkJeffrey P. Gold - University of Nebraska Medical CenterStephen J. Lahey - University of ConnecticutDesmond Jordan - NewYork–Presbyterian Hospital
- Publication Details
- The Annals of thoracic surgery, v 112(2), pp 555-562
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000678159900030
- Scopus ID
- 2-s2.0-85110573056
- Other Identifier
- 991019168813004721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery