Temporal trends in revascularization strategy and outcomes in left main XXXX : data from the asan medical center-left main revascularization registry.

@entity1 @entity64 @entity27399 @entity3979 @entity583 @entity204 @entity13830 @entity13831
BACKGROUND: Changes over time in revascularization strategies and outcomes among @entity1 with unprotected left main @entity3979 remain largely unknown. METHODS AND RESULTS: A total of 2618 consecutive @entity1 with unprotected left main @entity3979 who underwent revascularization were identified from the ASAN Medical Center-Left MAIN Revascularization registry and classified by time periods: bare metal stent ( @entity13830 , 1995-1998), early drug-eluting stents ( @entity13831 , 2003-2006), and late drug-eluting stents ( @entity27399 , 2007-2010). Primary end point was major adverse cerebrocardiovascular events (the composite of @entity204 , @entity583 , repeat revascularization, and @entity64 ). During the study period, 1124 @entity1 underwent percutaneous coronary intervention (PCI) and 1494 @entity1 underwent coronary artery bypass grafting. The proportion of PCI significantly increased from 35% to 52% between waves 1 and 3. In @entity1 receiving PCI, the risk-adjusted incidence rate of major adverse cerebro-cardiovascular events decreased from 20.18 cases per 100 @entity1 -years in @entity13830 to 6.77 cases per 100 @entity1 -years in @entity27399 (P<0.001 for trend). @entity204 , the composite of @entity204 , @entity583 , @entity64 , and repeat revascularization were also significantly decreased by 40%, 35%, and 46%, respectively. The risk-adjusted incidence rate of major adverse cerebrocardiovascular events did not change in @entity1 receiving coronary artery bypass grafting. The difference major adverse cerebrocardiovascular events risk between PCI and coronary artery bypass grafting progressively reduced (adjusted hazard ratio [95% confidence interval], 0.33 [0.23-0.47]; 0.53 [0.35-0.80]; and 1.01 [0.68-1.49] from @entity13830 to @entity27399 . CONCLUSIONS: The outcomes of unprotected left main coronary artery PCI have significantly improved over time. In addition, more @entity1 received PCI for unprotected left main @entity3979 in recent years.
