Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Artery Disease: Extended Follow-Up Outcomes of Multicenter Randomized Controlled BEST Trial. Issue 21 (19th September 2022)

• Record Type: Journal Article
• Authors: Ahn, Jung-Min; Kang, Do-Yoon; Yun, Sung-Cheol; Ho Hur, Seung; Park, Hun-Jun; Tresukosol, Damras; Chol Kang, Woong; Moon Kwon, Hyuck; Rha, Seung-Woon; Lim, Do-Sun; Jeong, Myung-Ho; Lee, Bong-Ki; Huang, He; Hyo Lim, Young; Ho Bae, Jang; Ok Kim, Byung; Kiam Ong, Tiong; Gyun Ahn, Sung; Chung, Cheol-Hyun; Park, Duk-Woo; Park, Seung-Jung
• Other Names: Ahn Jung-Min author non-byline.; Kang Do-Yoon author non-byline.; Yun Sung-Cheol author non-byline.; Park Duk-Woo author non-byline.; Chung Cheol-Hyun author non-byline.; Park Seung-Jung author non-byline.; Ho Hur Seung author non-byline.; Park Hun-Jun author non-byline.; Tresukosol Damras author non-byline.; Kang Woong Chol author non-byline.; Kwon Hyuck Moon author non-byline.; Lim Do-Sun author non-byline.; Rha Seung-Woon author non-byline.; Jeong Myung-Ho author non-byline.; Lee Bong-Ki author non-byline.; Huang He author non-byline.; Lim Young Hyo author non-byline.; Bae Jang Ho author non-byline.; Kim Byung Ok author non-byline.; Ong Tiong Kiam author non-byline.; Ahn Sung Gyun author non-byline.; Yang Tae-Hyun author non-byline.; Kim Byeong-Keuk author non-byline.; Jang Ji-Yong author non-byline.; Park Jong-Seon author non-byline.; Ge JunBo author non-byline.; Lee Sung Yun author non-byline.; Kim Jun-Hong author non-byline.; Cho Jang-Hyun author non-byline.; Choi Yun Seok author non-byline.; Park Gyung-Min author non-byline.; Zambahari Robaaya author non-byline.;
• Is Part Of: Circulation. Volume 146:Issue 21(2022)
• Page Start: 1581
• Page End: 1590
• Publication Date: 2022-09-19
• Subjects: coronary artery bypass -- coronary artery disease -- percutaneous coronary intervention -- stents; Blood -- Circulation -- Periodicals; Cardiovascular system -- Periodicals; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Blood Circulation; Cardiovascular System; Vascular Diseases; 616.1
• DOI: 10.1161/CIRCULATIONAHA.122.062188
• Languages: English
• ISSNs: 0009-7322

Abstract

Abstract : Background: Long-term comparative outcomes after percutaneous coronary intervention (PCI) with everolimus-eluting stents and coronary artery bypass grafting (CABG) are limited in patients with multivessel coronary artery disease. Methods: This prospective, multicenter, randomized controlled trial was conducted in 27 international heart centers and was designed to randomly assign 1776 patients with angiographic multivessel coronary artery disease to receive PCI with everolimus-eluting stents or CABG. After inclusion of 880 patients (438 in the PCI group and 442 in the CABG group) between July 2008 and September 2013, the study was terminated early because of slow enrollment. The primary end point was the composite of death from any cause, myocardial infarction, or target vessel revascularization. Results: During a median follow-up of 11.8 years (interquartile range, 10.6–12.5 years; maximum, 13.7 years), the primary end point occurred in 151 patients (34.5%) in the PCI group and 134 patients (30.3%) in the CABG group (hazard ratio [HR], 1.18 [95% CI, 0.88–1.56]; P =0.26). No significant differences were seen in the occurrence of a safety composite of death, myocardial infarction, or stroke between groups (28.8% and 27.1%; HR, 1.07 [95% CI, 0.75–1.53]; P =0.70), as well as the occurrence of death from any cause (20.5% and 19.9%; HR, 1.04 [95% CI, 0.65–1.67]; P =0.86). However, spontaneous myocardial infarction (7.1% and 3.8%; HR, 1.86 [95% CI, 1.06–3.27]; P =0.031) and any repeat revascularization (22.6% and 12.7%; HR, 1.92 [95% CI, 1.58–2.32]; P <0.001) were more frequent after PCI than after CABG. Conclusions: In patients with multivessel coronary artery disease, there were no significant differences between PCI and CABG in the incidence of major adverse cardiac events, the safety composite end point, and all-cause mortality during the extended follow-up. Registration: URL: https://www.clinicaltrials.gov ; Unique identifiers: NCT05125367 and NCT00997828.