Which Intervention for Patients with Left-Main Coronary Artery Disease?

A 10-year follow-up of a medium-sized randomized trial suggests that percutaneous coronary intervention can be reasonable — for selected patients.

Historically, patients with significant left-main coronary artery disease (CAD) have been managed with coronary-artery bypass grafting (CABG), based on findings of substantially better survival with CABG compared to medical therapy. Recent improvements in drug-eluting stents (DES), adjunct pharmacology, and intravascular imaging have renewed clinicians' interest in using percutaneous coronary intervention (PCI) for these patients, but several randomized trials suggesting similar death rates involved only 5-year follow-up. To evaluate longer-term outcomes, investigators performed an extended follow-up (≥10 years; NCT03871127) of 600 patients with significant left-main CAD who had been randomized to PCI with first-generation sirolimus-eluting…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Which Intervention for Patients with Left-Main Coronary Artery Disease?

Topics

Reviewing Author