Comparison of Efficacy of Drug-Eluting Stents and Coronary Artery Bypass Grafting Surgery in Unprotected Left Main Coronary Artery Coronary Heart Disease

ZHAI Anran; WANG Yixiao; WANG Lingling

doi:10.3969/j.issn.1004-437X.2025.16.013

Abstract：Objective To observe the short-term and long-term efficacy of drug-eluting stents(DES)and coronary artery bypass grafting(CABG)surgery in unprotected left main coronary artery(ULMCA)coronary heart disease.Methods From January 2019 to December 2021,a total of 310 unprotected patients with left main coronary artery disease in the First Affiliated Hospital of Zhengzhou University were selected and divided into DES group(151 cases)and CABG group(159 cases)according to surgical methods.The clinical efficacy,complications,follow-up efficacy,and quantitative coronary arteriography(CAG)parameters for preoperative,1-day after surgey,and 2-year follow-up of the two groups were compared.Results Compared to the CABG group,the DES group had a higher surgical success rate(P＜0.05),a shorter hospital stay(P＜0.05),and a lower incidence of major adverse cardiovascular events(MACE)during the DES group's hospitalization(P＜0.05).There was no statistically difference in the incidence of complications in the two groups(P＞0.05).During follow-up,the DES group reviewed a higher proportion of CAG than the CABG group(P＜0.05),and there was no statistically difference in the incidence of the total MACE and intra-stental thrombosis in the two groups(P＞0.05).Repeated measurement variance analysis showed that the time effect of the minimum lumen diameter(MLD)and the degree of narrowing of the tubular cavity was statistically significant(P＜0.05),compared with the pre-operative,the MLD of the two groups 1 day after surgery and followed up for 2 years were increased and the degree of narrowing of the tubular cavity were reduced(P＜0.05).Conclusion Compared to CABG,DES treatment for unprotected left main coronary heart disease has a higher success rate,faster patient recovery,and lower overall MACE incidence during hospitalization.However,the long-term efficacy of both treatments is comparable,and both can improve CAG parameters.