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Survival in patients with peripheral vascular disease after percutaneous coronary intervention and coronary artery bypass graft surgery.
Ann Thorac Surg. 2004 Aug; 78(2):466-70; discussion 470.AT

Abstract

BACKGROUND

Patients with peripheral vascular disease (PVD) undergoing coronary revascularization have high rates of adverse outcomes. Whether there are important differences in outcomes for surgical versus percutaneous coronary revascularization is unknown. The objective of this study was to compare survival in patients with PVD who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) surgery for multivessel coronary artery disease.

METHODS

In-hospital data were collected on 1,305 consecutive patients undergoing coronary revascularization (PCI, n = 341; CABG, n = 964) in northern New England from 1994 to 1996. Patient records were linked to the National Death Index to assess survival out to 3 years (mean 1.2 years). Logistic and Cox proportional hazards regression were used to calculate risk-adjusted odds ratios and hazard ratios.

RESULTS

Compared with CABG patients, those undergoing PCI were more often women, had more renal failure, more prior coronary revascularizations, were more likely to have two-vessel coronary artery disease and were more likely to undergo the procedure emergently. They were less likely to have a history of heart failure. After adjusting for differences in baseline characteristics, patients undergoing CABG had better intermediate survival than did PCI patients (hazard ratio 0.68; 95% confidence interval, 0.46 to 1.00; p = 0.05).

CONCLUSIONS

Patients with multivessel coronary artery disease and PVD undergoing CABG surgery have better intermediate survival out to 3 years than similar patients undergoing PCI. This information may be useful in counseling patients with PVD requiring coronary revascularization.

Authors+Show Affiliations

Section of Cardiology, Veterans Affairs Hospital, Hartland Road, White River Junction, Vermont 05006, USA. daniel.o'rourke@hitchcock.orgNo 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)

Journal Article
Review

Language

eng

PubMed ID

15276497

Citation

O'Rourke, Daniel J., et al. "Survival in Patients With Peripheral Vascular Disease After Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery." The Annals of Thoracic Surgery, vol. 78, no. 2, 2004, pp. 466-70; discussion 470.
O'Rourke DJ, Quinton HB, Piper W, et al. Survival in patients with peripheral vascular disease after percutaneous coronary intervention and coronary artery bypass graft surgery. Ann Thorac Surg. 2004;78(2):466-70; discussion 470.
O'Rourke, D. J., Quinton, H. B., Piper, W., Hernandez, F., Morton, J., Hettleman, B., Hearne, M., Nugent, W., O'Connor, G. T., & Malenka, D. J. (2004). Survival in patients with peripheral vascular disease after percutaneous coronary intervention and coronary artery bypass graft surgery. The Annals of Thoracic Surgery, 78(2), 466-70; discussion 470.
O'Rourke DJ, et al. Survival in Patients With Peripheral Vascular Disease After Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery. Ann Thorac Surg. 2004;78(2):466-70; discussion 470. PubMed PMID: 15276497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival in patients with peripheral vascular disease after percutaneous coronary intervention and coronary artery bypass graft surgery. AU - O'Rourke,Daniel J, AU - Quinton,Hebe B, AU - Piper,Winthrop, AU - Hernandez,Felix, AU - Morton,Jeremy, AU - Hettleman,Bruce, AU - Hearne,Michael, AU - Nugent,William, AU - O'Connor,Gerald T, AU - Malenka,David J, AU - ,, PY - 2004/01/22/accepted PY - 2004/7/28/pubmed PY - 2005/5/25/medline PY - 2004/7/28/entrez SP - 466-70; discussion 470 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 78 IS - 2 N2 - BACKGROUND: Patients with peripheral vascular disease (PVD) undergoing coronary revascularization have high rates of adverse outcomes. Whether there are important differences in outcomes for surgical versus percutaneous coronary revascularization is unknown. The objective of this study was to compare survival in patients with PVD who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) surgery for multivessel coronary artery disease. METHODS: In-hospital data were collected on 1,305 consecutive patients undergoing coronary revascularization (PCI, n = 341; CABG, n = 964) in northern New England from 1994 to 1996. Patient records were linked to the National Death Index to assess survival out to 3 years (mean 1.2 years). Logistic and Cox proportional hazards regression were used to calculate risk-adjusted odds ratios and hazard ratios. RESULTS: Compared with CABG patients, those undergoing PCI were more often women, had more renal failure, more prior coronary revascularizations, were more likely to have two-vessel coronary artery disease and were more likely to undergo the procedure emergently. They were less likely to have a history of heart failure. After adjusting for differences in baseline characteristics, patients undergoing CABG had better intermediate survival than did PCI patients (hazard ratio 0.68; 95% confidence interval, 0.46 to 1.00; p = 0.05). CONCLUSIONS: Patients with multivessel coronary artery disease and PVD undergoing CABG surgery have better intermediate survival out to 3 years than similar patients undergoing PCI. This information may be useful in counseling patients with PVD requiring coronary revascularization. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/15276497/Survival_in_patients_with_peripheral_vascular_disease_after_percutaneous_coronary_intervention_and_coronary_artery_bypass_graft_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003497504004254 DB - PRIME DP - Unbound Medicine ER -