UMEM Educational Pearls

Optimal Revascularization in Complex Coronary Artery Disease

- A multicenter trial 4,566 patients with NSTEMI, unstable angina, and multi-vessel coronary artery disease were enrolled comparing outcomes of cardiac stenting versus coronary artery bypass.

- Cardiac stenting was associated with improved outcomes and lower mortality in the following subgroups: age >65 years, women, unstable angina, TIMI score >4, and 2 vessel disease.

- Despite high clinical risk patients who underwent cardiac stenting compared to surgical revascularization did better in this prospective registry. 

References

Buszman P, Buszman P, Bochenek A, et al.  Comparison of Stenting and Surgical Revascularization Strategy in Non-ST Elevation Acute Coronary Syndromes and Complex Coronary Artery Disease (from the Milestone Registry). JACC  Oct 2014 Vol 114, Issue 7, pages 979-987.