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The impact of age on outcomes after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: one-year results from the Stent or Surgery (SoS) trial.
Am Heart J 2006; 152(6):1153-60AH

Abstract

BACKGROUND

Relative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) may differ between younger and older patients. There are no data comparing the age-related CABG versus PCI outcomes in the stent era.

METHODS

The SoS trial compared CABG (n = 500) and stent-assisted PCI (n = 488). The impact of treatment assignment on 1-year outcomes was evaluated by age < or = 65 years (n = 295, CABG; n = 298, PCI) and > 65 years (n = 205, CABG; n = 190, PCI).

RESULTS

One-year procedural outcomes were similar between treatment groups regardless of age, with the exception of more repeat revascularizations after PCI (age < or = 65, 16.1% vs 4.8%; age > 65, 19.5% vs 3.4%; both P < .001). Six and 12-month Seattle Angina Questionnaire scores improved from baseline in both age and treatment groups. However, CABG was associated with greater improvement in physical limitation, angina frequency, and quality of life in younger patients at 6 and 12 months (12-month difference in improvement between CABG and PCI: 5.6, 4.8, and 3.9 points for 3 domains), whereas in the elderly a significant benefit of CABG observed at 6 months did not persist at 12 months (12-month difference: 0.9, 1.9, and 1.4). One-year costs were significantly higher after CABG regardless of age.

CONCLUSIONS

Although PCI and CABG result in similar rates in clinical outcomes irrespective of age, younger patients reported more health status benefits from CABG as compared with PCI, whereas in older patients the 2 approaches resulted in similar 1-year health status benefits.

Authors+Show Affiliations

Christiana Care Center for Outcomes Research, Christiana Care Health System, Newark, DE 19713, USA. zzhang@christianacare.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17161069

Citation

Zhang, Zefeng, et al. "The Impact of Age On Outcomes After Coronary Artery Bypass Surgery Versus Stent-assisted Percutaneous Coronary Intervention: One-year Results From the Stent or Surgery (SoS) Trial." American Heart Journal, vol. 152, no. 6, 2006, pp. 1153-60.
Zhang Z, Mahoney EM, Spertus JA, et al. The impact of age on outcomes after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: one-year results from the Stent or Surgery (SoS) trial. Am Heart J. 2006;152(6):1153-60.
Zhang, Z., Mahoney, E. M., Spertus, J. A., Booth, J., Nugara, F., Kolm, P., ... Weintraub, W. S. (2006). The impact of age on outcomes after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: one-year results from the Stent or Surgery (SoS) trial. American Heart Journal, 152(6), pp. 1153-60.
Zhang Z, et al. The Impact of Age On Outcomes After Coronary Artery Bypass Surgery Versus Stent-assisted Percutaneous Coronary Intervention: One-year Results From the Stent or Surgery (SoS) Trial. Am Heart J. 2006;152(6):1153-60. PubMed PMID: 17161069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of age on outcomes after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: one-year results from the Stent or Surgery (SoS) trial. AU - Zhang,Zefeng, AU - Mahoney,Elizabeth M, AU - Spertus,John A, AU - Booth,Jean, AU - Nugara,Fiona, AU - Kolm,Paul, AU - Stables,Rodney H, AU - Weintraub,William S, PY - 2005/11/01/received PY - 2006/06/16/accepted PY - 2006/12/13/pubmed PY - 2007/1/9/medline PY - 2006/12/13/entrez SP - 1153 EP - 60 JF - American heart journal JO - Am. Heart J. VL - 152 IS - 6 N2 - BACKGROUND: Relative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) may differ between younger and older patients. There are no data comparing the age-related CABG versus PCI outcomes in the stent era. METHODS: The SoS trial compared CABG (n = 500) and stent-assisted PCI (n = 488). The impact of treatment assignment on 1-year outcomes was evaluated by age < or = 65 years (n = 295, CABG; n = 298, PCI) and > 65 years (n = 205, CABG; n = 190, PCI). RESULTS: One-year procedural outcomes were similar between treatment groups regardless of age, with the exception of more repeat revascularizations after PCI (age < or = 65, 16.1% vs 4.8%; age > 65, 19.5% vs 3.4%; both P < .001). Six and 12-month Seattle Angina Questionnaire scores improved from baseline in both age and treatment groups. However, CABG was associated with greater improvement in physical limitation, angina frequency, and quality of life in younger patients at 6 and 12 months (12-month difference in improvement between CABG and PCI: 5.6, 4.8, and 3.9 points for 3 domains), whereas in the elderly a significant benefit of CABG observed at 6 months did not persist at 12 months (12-month difference: 0.9, 1.9, and 1.4). One-year costs were significantly higher after CABG regardless of age. CONCLUSIONS: Although PCI and CABG result in similar rates in clinical outcomes irrespective of age, younger patients reported more health status benefits from CABG as compared with PCI, whereas in older patients the 2 approaches resulted in similar 1-year health status benefits. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/17161069/The_impact_of_age_on_outcomes_after_coronary_artery_bypass_surgery_versus_stent_assisted_percutaneous_coronary_intervention:_one_year_results_from_the_Stent_or_Surgery__SoS__trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(06)00559-X DB - PRIME DP - Unbound Medicine ER -