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.
Study Type
OBSERVATIONAL
Enrollment
2,500
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine
Seoul, South Korea
RECRUITINGProportion of patients treated with PCI or medical treatment despite of recommendation for CABG surgery
Time frame: 1 month (After the revascularization strategy was finally decided)
Reason of ineligibility for CABG surgery
Time frame: 1 month (After the revascularization strategy was finally decided)
the composite of major cardiac and cerebrovascular event (MACCE)
Time frame: 1 year follow up after revascularization
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