Comparison of late (four years) functional health status between percutaneous transluminal angioplasty intervention and off-pump left internal mammary artery bypass grafting for isolated high-grade narrowing of the proximal left anterior descending coronary artery

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

“…Alternatively, in patients with multivessel disease and particularly left main disease, emergency CABG as a primary reperfusion strategy may be preferred. 50,441 Refractory cardiogenic shock unresponsive to revascularization may necessitate institution of more intensive cardiac support with a ventricular assist device or other hemodynamic support devices to allow for myocardial recovery or subsequent cardiac transplantation in suitable patients. or symptomatic relief also generally undergo revascularization before elective noncardiac surgery.…”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…69,[72][73][74][75][76][77][78][79][80][81][82][83] A retrospective cohort study of 14 766 consecutive patients undergoing isolated CABG identified a mortality benefit (OR: 0.45) for off-pump CABG in patients with a predicted risk of mortality Ͼ2.5%, 82 but a subsequent randomized comparison of off-pump CABG to traditional on-pump CABG in 341 high-risk patients (a Euroscore Ͼ5) showed no difference in the composite endpoint of all-cause death, acute MI, stroke, or a required reintervention procedure. 78 An analysis of data from the New York State Cardiac Surgery Reporting system did not demonstrate a reduction in mortality rate with off-pump CABG in any patient subgroup, including the elderly (age Ͼ80 years) or those with cerebrovascular disease, azotemia, or an extensively calcified ascending aorta.…”

2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

“…In contrast, MACCE occurred more often after DES implantation than after CABG in those with an intermediate or high SYNTAX score. 66 At 3 years of follow-up, the mortality rate was greater in subjects with 3-vessel CAD treated with DES than in those treated with CABG (6.2% versus 2.9%). The differences in MACCE at 5-year follow-up between those treated with DES or CABG increased with an increasing SYNTAX score.…”

“…In a meta-analysis of 24 268 patients with multivessel CAD treated with CABG or DES, 80 the incidences of death and MI were similar for the 2 procedures, but the frequency with which repeat revascularization was performed was roughly 4 times higher after DES implantation. Only 1 large RCT comparing CABG and DES implantation has been 66,81,82 Major adverse cardiac and cerebrovascular events (MACCE)-a composite of death, stroke, MI, or repeat revascularization during the 3 years after randomization-occurred in 20.2% of patients who had received CABG and 28.0% of those who had undergone DES implantation (P<0.001). The rates of death and stroke were not significantly different; however, MI (3.6% for CABG, 7.1% for DES) and repeat revascularization (10.7% for CABG, 19.7% for DES) were more likely to occur with DES implantation.…”

“…66,81 In addition, 705 of the 1800 patients with unprotected left main CAD were randomized to either DES or CABG. The majority of patients with left main CAD and a low SYNTAX score had isolated left main CAD or left main CAD plus 1-vessel CAD.…”