CAD and AMI: Research Article Cardiology 2021;146:409–418 Age-Stratified Outcome in Treatment of Left Main Coronary Artery Stenosis: A NOBLE Trial Substudy Terje Steigen a, b Niels Ramsing Holm c Truls Myrmel a, d Petter C. Endresen d Thor Trovik b Timo Mäkikallio e Mitchell Lindsay f Mark S. Spence g Andrejs Erglis h Ian B.A. Menown i Indulis Kumsars h Thomas Kellerth j Giedrius Davidavičius k Rikard Linder l Vesa Anttila m Lone Juul Hune Mogensen c Per Hostrup Nielsen n Alastair N.J. Graham g David Hildick-Smith o Leif Thuesen p Evald Høj Christiansen c NOBLE Study Investigators a Cardiovascular Research Group, UiT The Arctic University of Norway, Tromsø, Norway; b Department of Cardiology, University Hospital of North Norway, Tromsø, Norway; c Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; d Department of Cardiovascular Surgery, University of Northern Norway, Tromsø, Norway; e Department of Cardiology, Oulu University Hospital, Oulu, Finland; f Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK; g Belfast Heart Centre, Belfast Trust, Belfast, UK; h Latvia Centre of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia; i Craigavon Cardiac Centre, Craigavon, UK; j Department of Cardiology, Örebro University Hospital, Örebro, Sweden; k Department of Cardiology, Vilnius University Hospital, Vilnius, Lithuania; l Department of Cardiology, Danderyd Hospital, Stockholm, Sweden; m Department of Cardiac Surgery, Oulu University Hospital, Oulu, Finland; n Department of Cardiac Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark; o Sussex Cardiac Centre, Brighton and Sussex University Hospital, Brighton, UK; p Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark Received: December 12, 2020 Accepted: January 26, 2021 Published online: April 13, 2021 Correspondence to: Evald Høj Christiansen, evald.christiansen @dadlnet.dk © 2021 S. Karger AG, Basel karger@karger.com www.karger.com/crd What Is Known • Little is known about the long-term outcome after revascularization of left main coronary artery dis- ease, after coronary artery bypass grafting or percutaneous coronary intervention in older age. What the Study Adds • In revascularization of left main coronary artery disease, age of 67 years or older was associated with lower 5-year major adverse cardiac or cerebrovascular events after coronary artery bypass grafting than percutaneous coronary intervention. Clinical outcomes were not significantly different in the sub- group younger than 67 years. DOI: 10.1159/000515376 Keywords Left main coronary artery · Percutaneous coronary intervention · Coronary artery bypass grafting · Age · Old Abstract Background: In the treatment of left main coronary artery (LMCA) disease, patients’ age may affect the clinical out- come after percutaneous coronary intervention (PCI) or cor- onary artery bypass grafting (CABG). This study stratified the