{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:27:34Z","timestamp":1762507654968,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T00:00:00Z","timestamp":1549324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary\u2010artery bypass grafting (CABG) on clinical outcomes in ostial or shaft left main coronary artery (LMCA) disease has evolved over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 2,112 patients with ostial or shaft LMCA disease from IRIS\u2010MAIN registry who underwent PCI (<jats:italic>n<\/jats:italic>\u2009=\u20091,329) or CABG (<jats:italic>n<\/jats:italic>\u2009=\u2009783). Patients were stratified by time period based on stent type availability: wave 1 (1995\u20132002, bare\u2010metal stent [BMS] era); wave 2 (2003\u20132006, first\u2010generation drug\u2010eluting stent [DES] era); and wave 3 (2007\u20132014, second\u2010generation DES era).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to CABG, PCI has been used more frequently from wave 1 to wave 3. PCI showed substantial improvements over time with respect to death (<jats:italic>P<\/jats:italic> for trend\u2009= 0.012); the composite of death, myocardial infarction (MI), or stroke (<jats:italic>P<\/jats:italic> for trend\u2009=\u20090.047); repeat revascularization (<jats:italic>P<\/jats:italic> for trend\u2009&lt;\u20090.001); and major adverse cardiac and cerebrovascular events (MACCE; a composite of death, MI, stroke, or repeat revascularization) (<jats:italic>P<\/jats:italic> for trend\u2009&lt;\u20090.001). By contrast, outcomes of CABG remained relatively stable over time. The gap between the treatment effects of CABG vs PCI for MACCE has narrowed over time; the adjusted hazard ratios for CABG compared to PCI during wave 1, 2, and 3 were 0.41 (95% confidence interval [CI]: 0.22\u20130.76), 0.47 (95% CI: 0.31\u20130.71), and 0.78 (95% CI: 0.50\u20131.20), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with ostial or shaft LMCA disease, significant improvements in PCI outcomes resulted in a progressive decline in the gap between the outcomes of CABG and PCI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28119","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T04:56:39Z","timestamp":1549428999000},"page":"315-322","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010term trends of treatment effect of stenting or bypass surgery in patients with ostial or shaft left main coronary artery disease"],"prefix":"10.1002","volume":"94","author":[{"given":"Yong\u2010Hoon","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Cardiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pil Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Do\u2010Yoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South 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University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6643-0239","authenticated-orcid":false,"given":"Duk\u2010Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6307-0562","authenticated-orcid":false,"given":"Seung\u2010Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center, University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the IRIS\u2010MAIN Registry 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