Prevention of childhood drowning on a Greek island in the 19th century: literal testimonies by two native writers

Background: To present literal texts of two native writers about drowning during childhood, along witha successful simple preventive measure implemented by the community of a small Greek island.Materials and methods: Review of the older Greek literal production as well as of the contemporary literatureon childhood drowning and related preventive measures.Results: Alexander Papadiamandis (1851–1911) from the island of Skiathos is a writer, who described,with intellectual language, the microcosm of his place of birth, which he always remembered with nostalgia.Alexander Moraitidis (1850–1929), his cousin, also from the same island, used a different style to describelife events in the small society. Both refer to tragic intentional and unintentional drowning events in wellsand the sea, which took place in their times or before and survived as local legends in their narrations.Both describe effective initiatives undertaken by families themselves to prevent childhood drowning byhiring, during the summer months, a guardian with a specific duty to closely supervise the children andenforce guidelines for swimming in the sea. Papadiamantis goes one step further to describe the dismalconsequences when the rules were not respected.Conclusions: The literal testimonies of two Greek islander writers present the range of childhood drowningoccurring on the island and a primitive yet effective community initiative for accident and drowningprevention pertaining to better supervision by an ad hoc employed guardian; this sets the example of thesocial responsibility ethos on the part of local communities to safeguard children from drowning that couldserve as a good practice even in modern times

Clinical effectiveness of drug eluting stents and bare metal stents

In this Thesis, long-term outcomes of 600 patients with chronic stable angina and an isolated de-novo lesion in the pLAD that underwent PCI with Endeavor-zotarolimus eluting stents (E-ZES) (Ν=180) and everolimus eluting stents (EES) (Ν=420) were compared. Mean clinical follow-up was 54,9 + 25,6 months. The study's primary endpoint was Target Lesion Failure (TLF), defined by its composites in hierarchical order: cardiac death, non-fatal MI not clearly attributed to a non-target vessel and clinically-driven revascularization of the target lesion (Target Lesion Revascularization - TLR). Secondary endpoints were Patient-Related Outcome (PRO – a composite index of all-cause mortality, any myocardial infarction related to any coronary artery, any revascularization conducted to any coronary artery), stent thrombosis and the components of TLF (cardiac death, non-fatal myocardial infarction and TLR). The use of EES in isolated de-novo pLAD lesions, led to substantially reduced clinical events in comparison to E-ZES. At 5 years, statistically significant differences between the two groups in the cumulative probability for TLF (13.8% for the E-ZES group versus 7.5% for the EES group, p=0.025) and for TLR (10% for the E-ZES group versus 3.3% for the EES group, p=0.003) were observed. No difference was observed concerning the remaining clinical outcomes. Differences between stents regarding TLF increased after 30 months. In multivariate analysis predictors of TLF adjusted for stent type were Diabetes mellitus and impaired estimated Glomerular Filtration Rate (eGFR).We also compared the long-term outcomes of PCI-DES and CABG with the left internal mammary artery in stable angina patients with isolated single-vessel pLAD disease. We included 631 PCI-DES patients and 379 CABG patients. The study’s primary endpoint was the occurrence of MACEs, namely, cardiac death, myocardial infarction not attributed to a non-target vessel and target lesion revascularization (using either the percutaneous or surgical technique) as a composite index. Secondary endpoints were Patient-Related Outcome, individual components of MACEs, recurrence of stable or unstable angina or a nonfatal arrhythmia (atrial fibrillation, atrial flutter or nonsustained ventricular tachycardia), duration of hospitalization, any complication (periprocedural or in-hospital) and CAD progression of other lesions (namely, nontarget vessel myocardial infarction, new onset of a nontarget vessel/lesion attributed stable angina determined by cardiac scintigraphy stress-test and/or angiography). Unadjusted and adjusted hazard ratios (HRs) were derived for all main outcomes. The main finding of the comparison was that long-term MACE rates were comparable between the two groups, despite a borderline significantly lower risk of repeat revascularization in the CABG group than in the PCI group. Moreover, no significant difference was observed between the two cohorts with respect to the risk of MACEs, PRO, cardiac death and nonfatal myocardial infarction. Compared with CABG, PCI-DES had a borderline significantly greater risk of repeat revascularization (HR:1.99, 95% CI:1.00-3.94, p=0.05; HR:1.95, 95% CI:0.98-3.9, p=0.06). The risk for the recurrence of stable angina was significantly increased in the PCI group compared to the CABG group (p<0.001), but the risk for non fatal arrhythmia occurrence (atrial fibrillation, atrial flutter or nonsustained ventricular tachycardia) was greater in the surgery group than in the PCI group (p=0.02). The surgical approach was associated with higher rates of in-hospital complications (p<0.001) and longer duration of hospitalization (p<0.001) compared with those in the PCI group.In conclusion, both EES and E-ZES stents provided a favorable safety profile, with EES demonstrating better effectiveness regarding TLF and TLR. The long-term clinical outcomes of second-generation PCI-DES and CABG in patients with stable angina and isolated pLAD disease were comparable, highlighting the excellent long-term outcomes of both the surgical and DES-PCI approaches. A similar cardiac mortality rate and myocardial infarction risk might be slightly offset by an increased risk of repeat revascularization with second-generation DES-PCI in the treatment of isolated pLAD disease, although overall MACEs were similar.Στην παρούσα διατριβή συγκρίθηκαν σε 600 ασθενείς οι μακροπρόθεσμες εκβάσεις χρόνιας σταθερής στηθάγχης και μονήρους de-novo βλάβης στο εγγύς τμήμα του προσθίου κατιόντα που υποβλήθηκαν σε διαδερμική στεφανιαία παρέμβαση με επικαλυμμένα stents εκλυτικής ουσίας zotarolimus (E-ZES) (Ν=180) με εκείνες ασθενών ιδίου προβλήματος και αντιμετώπισης με εκλυτική ουσία everolimus (EES) (Ν=420), με μέση κλινική παρακολούθηση τους 54,9 + 25,6 μήνες. Το πρωταρχικό τελικό σημείο της μελέτης ήταν η «αποτυχία» της βλάβης στόχου (Target Lesion Failure- TLF), ένας σύνθετος δείκτης, που καθορίζεται με ιεραρχική σειρά από: καρδιακό θάνατο, μη θανατηφόρο έμφραγμα του μυοκαρδίου που δεν αποδίδεται σαφώς σε αγγείο άλλο από το αγγείο στόχο και την κλινικά κατευθυνόμενη επαναγγείωση της βλάβης στόχου (Target Lesion Revascularization-TLR). Τα δευτερεύοντα καταληκτικά σημεία ήταν εκβάσεις σχετιζόμενες με τον ασθενή (PRO-σύνθετος δείκτης που απαρτίζουν η ολική θνησιμότητα, το έμφραγμα του μυοκαρδίου σε οποιοσδήποτε αγγείο, η επαναγγείωση σε οποιοδήποτε αγγείο), η θρόμβωση του stent και τα επιμέρους συστατικά του TLF (καρδιακός θάνατος, μη θανατηφόρο έμφραγμα του μυοκαρδίου και TLR). Η χρήση των EES σε μονήρεις de-novo βλάβες του LAD, οδήγησε σε στατιστικά σημαντική μείωση των κλινικών συμβαμάτων σε σύγκριση με τα E-ZES. Στα 5 χρόνια κλινικής παρακολούθησης, παρατηρήθηκαν στατιστικά σημαντικές διαφορές στη σωρευτική πιθανότητα εμφάνισης συμβαμάτων στην ομάδα ασθενών που έλαβαν E-ZES έναντι της ομάδας των ασθενών που έλαβαν EES μόνον αναφορικά με TLF (13,8% στην ομάδα E-ZES έναντι 7,5% στην ομάδα EES, p=0,025) και TLR (10% στην ομάδα E-ZES έναντι 3,3% στην ομάδα EES, p=0,003). Για όλες τις άλλες εκβάσεις δεν παρατηρήθηκαν διαφορές. Οι διαφορές μεταξύ των ενδοπροθέσεων ως προς το πρωτογενές καταληκτικό σημείο αυξήθηκαν μετά από 30 μήνες. Οι προγνωστικοί δείκτες του προτυπωμένου για τον τύπο του stent TLF ήταν ο σακχαρώδης διαβήτης και ο επηρεασμένος εκτιμώμενος ρυθμός σπειραματικής διήθησης (eGFR). Επιπλέον σε 631 ασθενείς με PCI-DES και 379 ασθενείς με CABG συγκρίθηκαν τα μακροπρόθεσμα αποτελέσματα της διαδερμικής στεφανιαίας παρέμβασης με δεύτερης γενιάς επικαλυμμένες ενδοπροθέσεις και της επέμβασης αορτοστεφανιαίας παράκαμψης με χρήση της αριστερής έσω μαστικής αρτηρίας σε ασθενείς με σταθερή στηθάγχη με μονήρη βλάβη στο εγγύς τμήμα του προσθίου κατιόντα. Το κύριο καταληκτικό σημείο της δεύτερης μελέτης ήταν η εμφάνιση σύνθετου δείκτη MACEs (καρδιακός θάνατος, έμφραγμα μυοκαρδίου που δεν αποδίδεται σαφώς σε αγγείο άλλο από το αγγείο στόχο και επαναγγείωση της βλάβης στόχου με χρήση διαδερμικής ή χειρουργικής τεχνικής. Δευτερεύοντα τελικά σημεία ήταν εκβάσεις σχετιζόμενες με τον ασθενή (PRO), καθώς και επιμέρους εκβάσεις των MACEs, επανεμφάνιση σταθερής ή ασταθούς στηθάγχης ή εμφάνιση μη θανατηφόρου αρρυθμίας, διάρκεια νοσηλείας, οποιαδήποτε επιπλοκή (περιεπεμβατική ή ενδονοσοκομειακή) και εξέλιξη της νόσου σε άλλα τμήματα (έμφραγμα μυοκαρδίου σε αγγείο άλλο από το αγγείο στόχο, νέα εμφάνιση σταθερής στηθάγχης που αποδίδεται σε αγγείο ή σε τμήμα αγγείου άλλο από το υπό μελέτη και που προσδιορίζεται με δοκιμασία ισχαιμίας-καρδιακό σπινθηρογράφημα ή/και αγγειογραφία). Υπολογίστηκαν οι μη προτυπωμένες και στη συνέχεια προτυπωμένες αναλογίες κινδύνου (HR) για τα υπό εξέταση κύρια συμβάματα. Το κύριο εύρημα ήταν ότι τα μακροπρόθεσμα ποσοστά MACE ήταν συγκρίσιμα μεταξύ των δύο ομάδων, παρά τον οριακά στατιστικά σημαντικό μικρότερο κίνδυνο της επαναγγείωσης στην ομάδα CABG από ό,τι στην ομάδα PCI. Συγκεκριμένα, δεν παρατηρήθηκε σημαντική διαφορά μεταξύ των δύο ομάδων κατά τη διάρκεια της κλινικής παρακολούθησης σχετικά με τα MACEs, το PRO, τον καρδιακό θάνατο και το έμφραγμα του μυοκαρδίου. Σε σύγκριση με το CABG, η PCI με δεύτερης γενιάς DES παρουσίασε σημαντικά μεγαλύτερο κίνδυνο επαναγγείωσης (HR PCI:1,99, 95% CI:1,00-3,94, p=0,05 και HR PCI:1,95, 95% CI:0,98-3,9, p=0,06). Ο κίνδυνος για την επανεμφάνιση σταθερής στηθάγχης ήταν σημαντικά αυξημένος στην ομάδα PCI σε σύγκριση με την ομάδα CABG (p <0,001), αλλά ο κίνδυνος εμφάνισης μη θανατηφόρας αρρυθμίας (κολπική μαρμαρυγή, κολπικός πτερυγισμός ή μη εμμένουσα κοιλιακή ταχυκαρδία) ήταν μεγαλύτερος στην ομάδα χειρουργικής επέμβασης από ό,τι στην ομάδα PCI (p=0,02). Η χειρουργική προσέγγιση συσχετίστηκε με υψηλότερα ποσοστά ενδονοσοκομειακών επιπλοκών (p <0,001) και μεγαλύτερης διάρκειας νοσηλεία (p <0,001) σε σύγκριση με εκείνα στην ομάδα PCI. Συμπερασματικά, και οι δύο τύποι stents, EES και E-ZES, επέδειξαν ένα ευνοϊκό προφίλ ασφαλείας. Η χρήση των EES φάνηκε στη μελέτη μας να έχει ελαφρώς καλύτερη αποτελεσματικότητα σε ορισμένους δείκτες (TLF, TLR). Οι μακροπρόθεσμες κλινικές εκβάσεις της δεύτερης γενιάς PCI-DES και του CABG σε ασθενείς με σταθερή στηθάγχη και μονήρη βλάβη στον pLAD ήταν συγκρίσιμες, υπογραμμίζοντας τα εξαιρετικά μακροπρόθεσμα αποτελέσματα τόσο της χειρουργικής όσο και της DES-PCI προσεγγίσεως. Τα παρόμοια ποσοστά καρδιακής θνησιμότητας και ο παραπλήσιος κίνδυνος του εμφράγματος του μυοκαρδίου μπορούν ελαφρώς να αντισταθμιστούν από τον αυξημένο κίνδυνο επανεπέμβασης στην ομάδα ασθενών που υποβλήθησαν σε PCI στον pLAD με δεύτερης γενιάς DES, αν και τα συνολικά MACEs ήταν παρόμοια

Validity of intraoperative gross examination of myometrial invasion in patients with endometrial cancer: a meta-analysis

Objective. The current recommended endometrial cancer surgical treatment is abdominal extrafascial total hysterectomy with bilateral salpingo-oophorectomy followed by pelvic lymphadenectomy if &gt;50% myometrial invasion is estimated by intraoperative gross examination (IGE). This meta-analysis aims to quantify evidence regarding the validity/predictive value of IGE staging compared with final histology. Design. Meta-analysis of studies published until October 2011. Setting. Systematic search, according to PRISMA guidelines, of the six major medical literature databases Medline, Scopus, EMBASE, Google Scholar, Ovid, Cochrane. Population. Sixteen eligible studies including 2567 endometrial cancer patients. Methods. Pooled sensitivity/specificity, accuracy, negative/positive predictive value (NPV/PPV) and diagnostic odds ratio (DOR) of IGE were calculated and the summary receiver operator characteristic (sROC) curve was constructed. A meta-regression analysis was used to explore the role of potential modifiers of sensitivity and specificity. Main outcome measures. Pooled diagnostic measures of IGE indices. Results. Sixteen studies (15 retrospective, one prospective) meeting the inclusion criteria were qualitatively analyzed. Pooled IGE estimates were: sensitivity = 0.75 (95%CI: 0.720.78), specificity = 0.92 (95%CI 0.900.94), accuracy = 0.87 (95%CI 0.860.88), NPV = 0.89 (95%CI 0.870.92), PPV = 0.80 (95%CI 0.760.84) and DOR = 36.9 (95%CI 28.747.4). No significant modifiers were identified for sensitivity or specificity. Conclusions. The synthesized measures presented here for the first time showed that accuracy, sensitivity and specificity of IGE were 87, 75 and 92%, respectively, which indicates that IGE is useful for estimating depth of myometrial invasion and staging of endometrial cancer in clinical practice. The degree to which the relatively low values of some of its performance indicators could be improved remains to be elucidated in order for the values to be comparable with those from frozen section biopsies

Clustering of excess health concerns for electromagnetic fields among health personnel: A quantitative and qualitative approach

Clustering patterns, among health-care personnel, of excessive concerns pertaining to perceived electromagnetic field-related health impacts, as contrasted to those from other environmental factors, were explored. Knowledge/excessive concerns of 722 health-care personnel were assessed using a 22-item structured questionnaire along with a double-phase qualitative study comprising semistructured interviews and focus groups. Over 75 percent of the participants had high perceived knowledge, whereas accuracy was limited to &lt;20 percent and correctness to 8 percent. An excessive concern group was clearly distinguished from a relaxed attitude one. Clustering of excessive concerns may derive from personal beliefs, suggesting a risk governance issue for health education policies

Female gender is independently associated with increased carotid temperatures in patients with coronary artery disease

Background : Limited are the data regarding the sex differences in functional carotid artery characteristics. Microwave Radiometry (MWR) is a new noninvasive method, which measures in vivo instantly the internal temperatures of tissues, reflecting inflammation. The aim of the present study was to investigate whether in patients with coronary artery disease (CAD), gender related differences apply in carotid plaque functional characteristics, as assessed by MWR. Methods : Consecutive patients with significant CAD were included in the study. All patients underwent evaluation of both carotid arteries by 1) ultrasound and 2) MWR. During ultrasound common carotid IMT and plaque thickness were assessed according to Mannheim consensus. During MWR measurements, temperature difference (ΔT) was assigned as maximal temperature along the carotid artery minus minimum. ΔT ≥ 0.90 °C was assigned as high ΔT. Results : In total 364 patients with significant CAD were included in the study. Of these 54 were female and 310 were male. Max plaque thickness and ccIMT were similar between males and females (2.38 ± 1.16 vs. 2.46 ± 1.12 mm, p = 0.63 and 0.944 ± 0.172 vs. 0.942 ± 0.169 mm, p = 0.96). Carotid arteries of females showed higher ΔT values (1.16 ± 0.48 vs 0.87 ± 0.45 °C, p < 0.001). Interestingly, females had more commonly high ΔT values bilaterally (35.2% vs 15.5%, p = 0.001). In multivariate analysis, female sex was independently associated with bilateral high ΔT, when adjusted to potential covariates (OR = 2.78, 95% CI = 1.42–5.45, p = 0.003). Conclusions : In patients with CAD, sex specific differences apply in functional but not in structural carotid artery characteristics. Whether this discrepancy has prognostic significance, remains to be clarified in future studies

Insulin resistance: an independent risk factor for lung cancer?

Insulin resistance is closely associated with numerous metabolic disorders. Although studies have supported the importance of insulin resistance in carcinogenesis, the existing data have not established its relevance in the context of lung cancer. The aim of the present case-control study was to evaluate the association between insulin resistance and lung cancer after adjusting for possible confounders. Homeostasis model assessment of insulin resistance (HOMA-IR) and serum leptin and adiponectin levels were determined in 81 lung cancer cases and 162 age-and sex-matched controls; anthropometric and lifestyle variables were recorded. Mean HOMA-IR in the cases was more than 2-fold higher compared with the mean value of controls (P &lt; .001). Among controls, HOMA-IR correlated positively with serum leptin (r = 0.16; P = .04), body mass index (r = 0.43; 13 = .0001), and waist-to-hip ratio (r = 0.21; P = .01) but negatively with serum adiponectin (r = -0.29; P = .0002). As expected, smoking was associated with an approximately 10-fold increase in lung cancer risk in multiple logistic regression models. A positive association between HOMA-IR, treated as continuous variable, and lung cancer (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 1.16-1.99, P = .002, model 1) was demonstrated, which persisted after adjustment for somatometric and lifestyle variables (OR = 2.36, 95% CI: 1.00-5.55, P =.05, model 2). When serum adiponectin was also taken into account, the association seemed fairly robust (OR = 2.58, 95% CI: 1.11-6.01, P = .03, model 3); on the contrary, when serum leptin was added, the association remained positive, but lost its statistical significance (OR = 1.76, 95% CI: 0.78-3.98, P = .17, model 4). In the fully adjusted model, HOMA-IR was still positively, but only marginally, associated with lung cancer risk (OR = 2.02, 95% CI: 0.88-4.65, P = .10, model 5). Insulin resistance may represent a meaningful risk factor for lung cancer. (C) 2011 Elsevier Inc. All rights reserved

Female gender is independently associated with increased carotid temperatures in patients with coronary artery disease

Background: Limited are the data regarding the sex differences in functional carotid artery characteristics. Microwave Radiometry (MWR) is a new noninvasive method, which measures in vivo instantly the internal temperatures of tissues, reflecting inflammation. The aim of the present study was to investigate whether in patients with coronary artery disease (CAD), gender related differences apply in carotid plaque functional characteristics, as assessed by MWR. Methods: Consecutive patients with significant CAD were included in the study. All patients underwent evaluation of both carotid arteries by 1) ultrasound and 2) MWR. During ultrasound common carotid IMT and plaque thickness were assessed according to Mannheim consensus. During MWR measurements, temperature difference (Delta T) was assigned as maximal temperature along the carotid artery minus minimum. Delta T &gt;= 0.90 degrees C was assigned as high Delta T. Results: In total 364 patients with significant CAD were included in the study. Of these 54 were female and 310 were male. Max plaque thickness and ccIMT were similar between males and females (2.38 +/- 1.16 vs. 2.46 +/- 1.12 mm, p = 0.63 and 0.944 +/- 0.172 vs. 0.942 +/- 0.169 mm, p = 0.96). Carotid arteries of females showed higher Delta T values (1.16 +/- 0.48 vs 0.87 +/- 0.45 degrees C, p &lt; 0.001). Interestingly, females had more commonly high Delta T values bilaterally (35.2% vs 15.5%, p = 0.001). In multivariate analysis, female sex was independently associated with bilateral high Delta T, when adjusted to potential covariates (OR = 2.78, 95% CI = 1.42-5.45, p = 0.003). Conclusions: In patients with CAD, sex specific differences apply in functional but not in structural carotid artery characteristics. Whether this discrepancy has prognostic significance, remains to be clarified in future studies. (C) 2016 Elsevier Ireland Ltd. All rights reserved

Late differences in outcomes of patients with stable angina and an isolated lesion in the proximal left anterior descending artery treated with new-generation drug-eluting stents

Background: New-generation drug-eluting stents have demonstrated the mid-term efficacy and safety, but possible differences between stents may emerge in a long-term period. We compared long-term outcomes of patients with chronic stable angina and an isolated de-novo lesion in the proximal left anterior descending artery that underwent percutaneous coronary intervention with Endeavor-zotarolimus eluting stents (E-ZES) and everolimus eluting stents (EES). Methods: We prospectively enrolled 600 patients. Of these, 180 underwent E-ZES and 420 underwent EES implantation. Clinical follow-up was performed up to 7 years (median follow-up 61 months). The evaluated clinical outcomes were Target Lesion Failure (TLF), a composite of cardiac death, myocardial infarction and Target Lesion Revascularization (TLR), the Patient-Related Outcome (PRO) and stent thrombosis. Differences between groups evaluated with the Kaplan-Meier method and possible independent predictors with Cox proportional hazard regression. Results: At 5 years, the cumulative probability for outcomes was: TLF: 13.8% versus 7.5%, p = 0.025, cardiac death: 3.1% versus 2.5%, p = 0.937, myocardial infarction: 1.2% versus 1.8%, p = 0.829, TLR: 10% versus 3.3%, p = 0.003, PRO: 19.6% versus 13.8%, p = 0.528, ST: 2.5% versus 2.7%, p = 0.965, for E-ZES and EES respectively. Differences between stents increased after 30 months. In multivariate analysis predictors of TLF adjusted for stent type were Diabetes mellitus and estimated Glomerular Filtration Rate (eGFR). Conclusion: Both stents provided a favorable safety profile, with EES demonstrating better effectiveness. There was a late emergence in difference of endpoints after 30 months. Diabetes mellitus and eGFR predicted TLF. (C) 2015 Elsevier Ireland Ltd. All rights reserved

Long-term clinical outcomes of coronary artery bypass graft surgery compared to those of percutaneous coronary intervention with second generation drug eluting stents in patients with stable angina and an isolated lesion in the proximal left anterior descending artery

Objectives We compared the long-term outcomes of percutaneous coronary intervention with second-generation drug-eluting stents (PCI-DES) and coronary artery bypass graft surgery (CABG) with the left internal mammary artery in stable angina patients with isolated single-vessel proximal left anterior descending artery (pLAD) disease. Background Long-term outcomes of second-generation PCI-DES and CABG in isolated pLAD lesions have not been extensively studied. Methods We included 631 PCI-DES patients and 379 CABG patients. Unadjusted and adjusted hazard ratios (HRs) were derived for major adverse cardiac events (MACEs), their components (cardiac death, nonfatal myocardial infarction [MI] not attributed to a non-target vessel, target-lesion revascularization), and patient-related outcome (PRO, composed of all-cause mortality, any MI, any revascularization). Results In the unadjusted and adjusted analyses, no significant difference was observed between the two groups at follow-up (mean:4.6 +/- 2.5 years) for MACEs (HR: 1.45, 95% CI: 0.92-2.28,p= .11; HR:1.43, 95% CI: 0.91-2.26,p= .13), PRO (HR: 1.18, 95%CI: 0.86-1.61,p= .30; HR: 1.18, 95% CI: 0.86-1.62,p= .31), cardiac death (HR: 0.97, 95% CI: 0.46-2.05,p= .93; HR: 0.79, 95% CI: 0.36-1.72,p= .56) and MI (HR: 1.43, 95% CI: 0.49-4.13,p= .51; HR: 1.57, 95% CI: 0.53-4.64,p= .42). Compared with CABG, PCI-DES had a borderline significantly greater risk of repeat revascularization (HR: 1.99, 95% CI: 1.00-3.94,p= .05; HR: 1.95, 95% CI: 0.98-3.9,p= .06). Angina recurred more often after PCI (p &lt; .001), whereas more arrhythmias developed after CABG (p= .02). PCI-DES resulted in fewer in-hospital complications (p &lt; .001) and shorter hospitalizations (p &lt; .001). Conclusions The long-term clinical outcomes of second-generation PCI-DES and CABG in patients with stable angina and isolated pLAD disease were comparable