연령이 좌주간부 관상동맥질환에서 경피적 관상동맥중재술과 관상동맥우회술의 비교 임상결과에 미치는 영향: IRIS-MAIN 하위연구

Abstract

Introduction: Unprotected left main coronary artery(LMCA) disease was treated with coronary artery bypass grafting(CABG) and percutaneous coronary intervention(PCI). Age has emerged as a determinant in revascularization therapy decisions. With IRIS-MAIN registry, analysis of age-related clinical outcomes will offer critical insights into the optimal treatment strategies for LMCA disease. Objectives: This study examined long-term comparative outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), focusing on age. Methods: The authors evaluated a total of 5,354 patients with left main coronary artery disease who underwent CABG (n=1,534) or PCI (n=3,820) from the IRIS-MAIN (Interventional Research Incorporation Society-Left MAIN Revascularization) registry. The age was categorized into young age (age< 55 years old), mid-age (≥55 to <70 years old), and old age (≥70 years old) groups. The primary outcome was a composite of death, myocardial infarction, or stroke. Results: Among the overall patient population, 960 (17.9 %) patients were < 55 years old, 22,734 (51 %) patients were ≥55 to <70 years old, and 1,660 (31 %) patients were ≥70 years old. Compared with CABG, PCI showed relatively favoring outcomes after revascularization with mid-age group. CABG and PCI showed similar adjusted risk of primary outcomes in patients regardless of age groups (hazard ratio(HR) 0.92; 95% confidence interval(CI) 0.43-2.0 for young age, HR 1.14; 95% CI 0.80-1.62 for mid-age, HR 1.17; 95% CI 0.86-1.60, p for interaction 0.855). Conclusion: The age did not significantly impact the 5 year risk of death, myocardial infarction, or stroke among LMCA patients treated with PCI or CABG. Key words: coronary artery disease, percutaneous coronary intervention, coronary artery bypass Abstract word count: 285