Tags

Type your tag names separated by a space and hit enter

Three-year outcome after coronary stenting versus bypass surgery for the treatment of multivessel disease.
Circulation. 2004 Mar 09; 109(9):1114-20.Circ

Abstract

BACKGROUND

The primary results of Arterial Revascularization Therapy Study reported a greater need for repeated revascularization after percutaneous coronary intervention with stenting (PCI). However, PCI was less expensive than coronary artery bypass grafting (CABG) and offered the same degree of protection against death, stroke, and myocardial infarction.

METHODS AND RESULTS

Patients with multivessel disease (n=1205) were randomly assigned to either CABG or PCI and followed up for up to 3 years. Survival rates without stroke or myocardial infarction were similar in each group at 1 year and 3 years (90.5% versus 91.4% for PCI versus CABG at 1 year and 87.2% versus 88.4% for PCI versus CABG at 3 years). However, the respective repeat revascularization rates were 21.2% and 26.7% at 1 and 3 years in patients allocated to PCI, compared with 3.8% and 6.6% in patients allocated to CABG (P<0.0001). Diabetes (P<0.0009) and maximal pressure for stent deployment (P<0.002) are the strongest independent predictors of events at 3 years after PCI, whereas left anterior descending coronary artery grafting (P<0.006) is the best predictor of event-free survival at 3 years after CABG. The incremental cost of surgery compared with PCI for an event-free patient was 19 257 at 1 year but decreased to 10 492 at 3 years. It remained at 142 391 at 3 years when revascularization procedures were excluded in the efficacy end point, however.

CONCLUSIONS

Three-year survival rates without stroke and myocardial infarction are identical in both groups, and the cost/benefit ratio of stenting is determined primarily by the increasing need for revascularization in the PCI group.

Authors+Show Affiliations

CHU Sart-Tilman, Liège, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

14993134

Citation

Legrand, Victor M G., et al. "Three-year Outcome After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease." Circulation, vol. 109, no. 9, 2004, pp. 1114-20.
Legrand VM, Serruys PW, Unger F, et al. Three-year outcome after coronary stenting versus bypass surgery for the treatment of multivessel disease. Circulation. 2004;109(9):1114-20.
Legrand, V. M., Serruys, P. W., Unger, F., van Hout, B. A., Vrolix, M. C., Fransen, G. M., Nielsen, T. T., Paulsen, P. K., Gomes, R. S., de Queiroz e Melo, J. M., Neves, J. P., Lindeboom, W., & Backx, B. (2004). Three-year outcome after coronary stenting versus bypass surgery for the treatment of multivessel disease. Circulation, 109(9), 1114-20.
Legrand VM, et al. Three-year Outcome After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease. Circulation. 2004 Mar 9;109(9):1114-20. PubMed PMID: 14993134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Three-year outcome after coronary stenting versus bypass surgery for the treatment of multivessel disease. AU - Legrand,Victor M G, AU - Serruys,Patrick W, AU - Unger,Felix, AU - van Hout,Ben A, AU - Vrolix,Mathias C M, AU - Fransen,Geert M P, AU - Nielsen,Torsten Toftegaard, AU - Paulsen,Peter Kildeberg, AU - Gomes,Ricardo Seabra, AU - de Queiroz e Melo,João M G, AU - Neves,José P Marques dos Santos, AU - Lindeboom,Wietze, AU - Backx,Bianca, AU - ,, Y1 - 2004/03/01/ PY - 2004/3/3/pubmed PY - 2004/5/25/medline PY - 2004/3/3/entrez SP - 1114 EP - 20 JF - Circulation JO - Circulation VL - 109 IS - 9 N2 - BACKGROUND: The primary results of Arterial Revascularization Therapy Study reported a greater need for repeated revascularization after percutaneous coronary intervention with stenting (PCI). However, PCI was less expensive than coronary artery bypass grafting (CABG) and offered the same degree of protection against death, stroke, and myocardial infarction. METHODS AND RESULTS: Patients with multivessel disease (n=1205) were randomly assigned to either CABG or PCI and followed up for up to 3 years. Survival rates without stroke or myocardial infarction were similar in each group at 1 year and 3 years (90.5% versus 91.4% for PCI versus CABG at 1 year and 87.2% versus 88.4% for PCI versus CABG at 3 years). However, the respective repeat revascularization rates were 21.2% and 26.7% at 1 and 3 years in patients allocated to PCI, compared with 3.8% and 6.6% in patients allocated to CABG (P<0.0001). Diabetes (P<0.0009) and maximal pressure for stent deployment (P<0.002) are the strongest independent predictors of events at 3 years after PCI, whereas left anterior descending coronary artery grafting (P<0.006) is the best predictor of event-free survival at 3 years after CABG. The incremental cost of surgery compared with PCI for an event-free patient was 19 257 at 1 year but decreased to 10 492 at 3 years. It remained at 142 391 at 3 years when revascularization procedures were excluded in the efficacy end point, however. CONCLUSIONS: Three-year survival rates without stroke and myocardial infarction are identical in both groups, and the cost/benefit ratio of stenting is determined primarily by the increasing need for revascularization in the PCI group. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/14993134/Three_year_outcome_after_coronary_stenting_versus_bypass_surgery_for_the_treatment_of_multivessel_disease_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000118504.61212.4B?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -