Coronary Artery Disease
Conditions
Brief summary
According to 2011 ACCF/AHA guideline and 2014 ESC/EACTS guideline, CABG surgery was recommended for three-vessel coronary artery disease and left main coronary artery disease in the patients with stable ischemic heart disease as class I. 2-VD with proximal left anterior descending artery stenosis was also indicated for CABG surgery as class I recommendation. However, many patients have been recommended for PCI by catheterization laboratory cardiologist; 46% and 93% in the only-CABG candidates and both CABG and PCI candidates, retrospectively, defined by previous ACC/AHA guideline. Although the discordance between real practice in catheterization laboratory and guideline would be adjusted by recently updated guideline. The revascularization strategy for patients with 3-VD/LMD in real practice have been getting toward more PCI and less CABG surgery. In this study, we will identify the rate of CABG candidates who were treated with PCI or medical treatment instead of CABG surgery in different from current guideline. We are also going to compare two treatment strategies CABG surgery vs. PCI with 2nd generation DES regarding clinical outcomes.
Interventions
PROCEDURECABG surgery
Sponsors
Yonsei University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients ≥ 19 years old * Left main disease, three-vessel disease or two-vessel disease with proximal LAD stenosis.
Exclusion criteria
* Previous PCI within 1 year * Previous sternotomy * Primary PCI for STEMI * Contraindication or hypersensitivity to anti-platelet medications or contrast media * Planned need for concomitant other cardiac surgery (eg, valve surgery or resection of aortic or left ventricular aneurysm, etc) * Pregnant women or women with potential childbearing * Inability to follow the patient over the period of 1 year after enrollment, as assessed by the investigator * Inability to understand or read the informed content
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients treated with PCI or medical treatment despite of recommendation for CABG surgery | 1 month (After the revascularization strategy was finally decided) |
Secondary
| Measure | Time frame |
|---|---|
| Reason of ineligibility for CABG surgery | 1 month (After the revascularization strategy was finally decided) |
| the composite of major cardiac and cerebrovascular event (MACCE) | 1 year follow up after revascularization |
Countries
South Korea
Contacts
Primary ContactMyeong Ki Hong, MD, PhD
Outcome results
None listed