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Copyleft Clinical Trial Results. You Must Redistribute Slides MAIN-COMPARE Study Stents versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery.

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Presentation on theme: "Copyleft Clinical Trial Results. You Must Redistribute Slides MAIN-COMPARE Study Stents versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery."— Presentation transcript:

1 Copyleft Clinical Trial Results. You Must Redistribute Slides MAIN-COMPARE Study Stents versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery Disease

2 MAIN-COMPARE Study Presented at ACC / i in Chicago Presented by Dr. Seung-Jung Park MAIN-COMPARE Study Copyleft Clinical Trial Results. You Must Redistribute Slides

3 MAIN-COMPARE Study: Background Coronary artery bypass graft (CABG) surgery has been regarded as the standard of care in LMCA disease.Coronary artery bypass graft (CABG) surgery has been regarded as the standard of care in LMCA disease. Early trials of LMCA disease treatment with drug eluting stents (DES) suggest promising outcomes with respect to mortality.Early trials of LMCA disease treatment with drug eluting stents (DES) suggest promising outcomes with respect to mortality. Presented at SCAI-i2 summit 08

4 Copyleft Clinical Trial Results. You Must Redistribute Slides CABG surgery n=1138 Stent implantation n=1102 MAIN-COMPARE Study: Study Design DES n=784 BMS n= patients with unprotected left main artery disease, excluding those with prior CABG, valvular & aortic surgery, STEMI, or cardiogenic shock Prospective. Non-randomized. Observational. 49% underwent stent implantation and 51% underwent CABG surgery  Primary Endpoint: Death; the composite of death, Q-wave myocardial infarction or stroke; target vessel revascularization (TVR) days median follow-up 1152 days median follow-up 1017 days median follow-up 1017 days median follow-up Presented at SCAI-i2 summit 08 R R

5 Characteristic Stents ( n=1102 ) CABG (n=1138) P value Age (yr) Median Median Interquartile range Interquartile range <0.001 Male (%) Hypertension (%) Hyperlipidemia (%) Current smoker (%) Diabetes (%) Prior PCI (%) <0.001 Prior CVA Prior MI (%) MAIN-COMPARE Study: Baseline Characteristics Copyleft Clinical Trial Results. You Must Redistribute Slides Presented at SCAI-i2 summit 08

6 Characteristic Stents (n=1102 ) CABG (n=1138 ) P value Involved location (% patients) 0.04 LM ostium, mid shaft/ both (%) Distal bifurcation (%) Extent of disease vessel (% pts) <0.001 Left main only (%) LM+ 1 vessel disease (%) LM+ 2 vessel disease (%) LM+ 3 vessel disease (%) MAIN-COMPARE Study: Angiographic Characteristics Copyleft Clinical Trial Results. You Must Redistribute Slides Presented at SCAI-i2 summit 08

7 MAIN-COMPARE Study: Endpoints Overall cohort Copyleft Clinical Trial Results. You Must Redistribute Slides Presented at SCAI-i2 summit 08EventsHR 95% CI P value Death Composite (death, Q-wave MI, or stroke) TVR p<0.001 HR is risk of stenting in excess of CABG

8 MAIN-COMPARE Study: Endpoints BMS vs. CABG Copyleft Clinical Trial Results. You Must Redistribute Slides Presented at SCAI-i2 summit 08EventsHR 95% CI P value Death Composite (death, Q-wave MI, or stroke) TVR p<0.001 HR is risk of stenting in excess of CABG

9 MAIN-COMPARE Study: Endpoints DES vs. CABG Copyleft Clinical Trial Results. You Must Redistribute Slides Presented at SCAI-i2 summit 08EventsHR 95% CI P value Death Composite (death, Q-wave MI, or stroke) TVR p<0.001

10 Copyleft Clinical Trial Results. You Must Redistribute Slides MAIN-COMPARE Study: Limitations This was a non-randomized, observational study, thus the results may have been influenced by confounders.This was a non-randomized, observational study, thus the results may have been influenced by confounders. Additionally, a larger sample size is needed to appropriately power the study in order to detect significant differences in mortality.Additionally, a larger sample size is needed to appropriately power the study in order to detect significant differences in mortality. Presented at SCAI-i2 summit 08

11 Copyleft Clinical Trial Results. You Must Redistribute Slides MAIN-COMPARE Study: Summary The results of this study suggest that there is no significant difference in the mortality rate or the composite risk of death, Q-wave MI or stroke among patients with unprotected LMCA disease who undergo PCI vs. CABG.The results of this study suggest that there is no significant difference in the mortality rate or the composite risk of death, Q-wave MI or stroke among patients with unprotected LMCA disease who undergo PCI vs. CABG. However, CABG was associated with significant reduction in the incidence of target vessel revascularization compared to PCI.However, CABG was associated with significant reduction in the incidence of target vessel revascularization compared to PCI. Presented at SCAI-i2 summit 08


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