{
    "abstract": "Most studies of patients with isolated proximal left anterior descending (PLAD) coronary artery disease do not include all 3 procedural options: percutaneous coronary intervention (PCI), conventional coronary artery bypass graft (CABG) surgery, or minimally invasive CABG.\nNew York's cardiac registries were used to identify patients who underwent revascularization for isolated PLAD disease between January 1, 2010, and November 30, 2016, in New York State. After exclusions, 14,327 patients, of whom 13,115 received PCI, 1001 of whom underwent CABG surgery, and 211 of whom underwent minimally invasive CABG were monitored through the end of 2017 to compare outcomes. Registry data were matched to vital statistics data to obtain deaths occurring after discharge and matched to claims data to obtain subsequent admissions for myocardial infarction and stroke.\nThere were no significant differences in mortality or in mortality/myocardial infarction/stroke after 7 years (with median follow-up times in excess of 4 years) among the 3 procedures after adjusting for\u00a0differences in patient risk factors. However, conventional CABG surgery was associated with a lower subsequent revascularization rate than PCI (adjusted hazard ratio, 0.45; 95% confidence interval, 0.35-0.58) and minimally invasive CABG surgery (adjusted hazard ratio, 0.46; 95% confidence interval, 0.32-0.66).\nAmong patients with isolated PLAD disease undergoing any of 3 revascularization options (PCI, conventional CABG surgery, or minimally invasive CABG surgery), conventional CABG surgery was associated with lower subsequent revascularization rates, but there were no differences in mortality or mortality/myocardial infarction/stroke rates.",
    "authors": [
        {
            "affiliation": "School of Public Health, University at Albany, State University of New York, Albany, New York. Electronic address: edward.hannan@health.ny.gov.",
            "firstname": "Edward L",
            "initials": "EL",
            "lastname": "Hannan"
        },
        {
            "affiliation": "School of Public Health, University at Albany, State University of New York, Albany, New York.",
            "firstname": "Ye",
            "initials": "Y",
            "lastname": "Zhong"
        },
        {
            "affiliation": "School of Public Health, University at Albany, State University of New York, Albany, New York.",
            "firstname": "Kimberly",
            "initials": "K",
            "lastname": "Cozzens"
        },
        {
            "affiliation": "Department of Surgery, Mount Sinai Hospital, New York, New York.",
            "firstname": "David H",
            "initials": "DH",
            "lastname": "Adams"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York, New York.",
            "firstname": "Leonard",
            "initials": "L",
            "lastname": "Girardi"
        },
        {
            "affiliation": "Department of Cardiac Surgery, Cedars-Sinai Medical Center, Los Angeles, California.",
            "firstname": "Joanna",
            "initials": "J",
            "lastname": "Chikwe"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Drexel University, Philadelphia, Pennsylvania.",
            "firstname": "Andrew",
            "initials": "A",
            "lastname": "Wechsler"
        },
        {
            "affiliation": "Cardiac Surgical Division, Massachusetts General Hospital, Boston, Massachusetts.",
            "firstname": "Thoralf M",
            "initials": "TM",
            "lastname": "Sundt"
        },
        {
            "affiliation": "Department of Surgery, Columbia-Presbyterian Irving Medical Center, New York, New York.",
            "firstname": "Craig R",
            "initials": "CR",
            "lastname": "Smith"
        },
        {
            "affiliation": "Department of Administration, University of Nebraska Medical Center, Omaha, Nebraska.",
            "firstname": "Jeffrey P",
            "initials": "JP",
            "lastname": "Gold"
        },
        {
            "affiliation": "Division of Cardiothoracic Surgery, University of Connecticut, Storrs, Connecticut.",
            "firstname": "Stephen J",
            "initials": "SJ",
            "lastname": "Lahey"
        },
        {
            "affiliation": "Department of Anesthesiology, Columbia-Presbyterian Irving Medical Center, New York, New York.",
            "firstname": "Desmond",
            "initials": "D",
            "lastname": "Jordan"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.athoracsur.2020.08.049",
    "journal": "The Annals of thoracic surgery",
    "keywords": [],
    "methods": null,
    "publication_date": "2020-11-05",
    "pubmed_id": "33144114",
    "results": "There were no significant differences in mortality or in mortality/myocardial infarction/stroke after 7 years (with median follow-up times in excess of 4 years) among the 3 procedures after adjusting for\u00a0differences in patient risk factors. However, conventional CABG surgery was associated with a lower subsequent revascularization rate than PCI (adjusted hazard ratio, 0.45; 95% confidence interval, 0.35-0.58) and minimally invasive CABG surgery (adjusted hazard ratio, 0.46; 95% confidence interval, 0.32-0.66).",
    "title": "Revascularization for Isolated Proximal Left Anterior Descending Artery Disease.",
    "xml": "<Element 'PubmedArticle' at 0x788502d04b30>"
}