Tags

Type your tag names separated by a space and hit enter

Surgical revascularization is associated with improved long-term outcomes compared with percutaneous stenting in most subgroups of patients with multivessel coronary artery disease: results from the Intermountain Heart Registry.
Circulation. 2007 Sep 11; 116(11 Suppl):I226-31.Circ

Abstract

BACKGROUND

Coronary artery bypass surgery (CABG) and percutaneous coronary intervention with stenting (PCI-S) are both safe and effective approaches for revascularization in patients with multivessel coronary artery disease. However, conflicting information exists when comparing the efficacy of the two methods. In this study, we examined the outcomes of major adverse cardiovascular events and death for subgroups of typical "real-world" patients undergoing coronary revascularization in the modern era.

METHODS AND RESULTS

Patients were included if they were revascularized by CABG or PCI-S, had > or = 5 years of follow-up, and had > or = 2-vessel disease. Patients were followed for an average of 7.0+/-3.2 years for incidence of death and major adverse cardiovascular events (death, myocardial infarction, or repeat revascularization). Multivariate regression models were used to correct for standard cardiac risk factors including age, sex, hyperlipidemia, diabetes mellitus, family history of coronary artery disease, smoking, hypertension, heart failure, and renal failure. Subgroup analyses were also performed, stratified by age, sex, diabetes, ejection fraction, and history of PCI-S, CABG, or myocardial infarction. A total of 6369 patients (CABG 4581; PCI-S 1788) were included. Age averaged 66+/-10.9 years, 76% were male, and 26% were diabetic. Multivariate risk favored CABG over PCI-S for both death (hazard ratio 0.85; P=0.001) and major adverse cardiovascular events (hazard ratio 0.51; P<0.0001). A similar advantage with CABG was also found in most substrata, including diabetes.

CONCLUSIONS

In this large observational study of patients undergoing revascularization for multivessel coronary artery disease, a long-term benefit was found, in relationship to both death and major adverse cardiovascular events, for CABG over PCI-S regardless of diabetic status or other stratifications.

Authors+Show Affiliations

Cardiovascular Department, University of Utah, Salt Lake City, USA.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 available

Pub Type(s)

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

Language

eng

PubMed ID

17846308

Citation

Bair, Tami L., et al. "Surgical Revascularization Is Associated With Improved Long-term Outcomes Compared With Percutaneous Stenting in Most Subgroups of Patients With Multivessel Coronary Artery Disease: Results From the Intermountain Heart Registry." Circulation, vol. 116, no. 11 Suppl, 2007, pp. I226-31.
Bair TL, Muhlestein JB, May HT, et al. Surgical revascularization is associated with improved long-term outcomes compared with percutaneous stenting in most subgroups of patients with multivessel coronary artery disease: results from the Intermountain Heart Registry. Circulation. 2007;116(11 Suppl):I226-31.
Bair, T. L., Muhlestein, J. B., May, H. T., Meredith, K. G., Horne, B. D., Pearson, R. R., Li, Q., Jensen, K. R., Anderson, J. L., & Lappé, D. L. (2007). Surgical revascularization is associated with improved long-term outcomes compared with percutaneous stenting in most subgroups of patients with multivessel coronary artery disease: results from the Intermountain Heart Registry. Circulation, 116(11 Suppl), I226-31.
Bair TL, et al. Surgical Revascularization Is Associated With Improved Long-term Outcomes Compared With Percutaneous Stenting in Most Subgroups of Patients With Multivessel Coronary Artery Disease: Results From the Intermountain Heart Registry. Circulation. 2007 Sep 11;116(11 Suppl):I226-31. PubMed PMID: 17846308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical revascularization is associated with improved long-term outcomes compared with percutaneous stenting in most subgroups of patients with multivessel coronary artery disease: results from the Intermountain Heart Registry. AU - Bair,Tami L, AU - Muhlestein,Joseph B, AU - May,Heidi T, AU - Meredith,Kent G, AU - Horne,Benjamin D, AU - Pearson,Robert R, AU - Li,Qunyu, AU - Jensen,Kurt R, AU - Anderson,Jeffrey L, AU - Lappé,Donald L, PY - 2007/9/14/pubmed PY - 2007/10/12/medline PY - 2007/9/14/entrez SP - I226 EP - 31 JF - Circulation JO - Circulation VL - 116 IS - 11 Suppl N2 - BACKGROUND: Coronary artery bypass surgery (CABG) and percutaneous coronary intervention with stenting (PCI-S) are both safe and effective approaches for revascularization in patients with multivessel coronary artery disease. However, conflicting information exists when comparing the efficacy of the two methods. In this study, we examined the outcomes of major adverse cardiovascular events and death for subgroups of typical "real-world" patients undergoing coronary revascularization in the modern era. METHODS AND RESULTS: Patients were included if they were revascularized by CABG or PCI-S, had > or = 5 years of follow-up, and had > or = 2-vessel disease. Patients were followed for an average of 7.0+/-3.2 years for incidence of death and major adverse cardiovascular events (death, myocardial infarction, or repeat revascularization). Multivariate regression models were used to correct for standard cardiac risk factors including age, sex, hyperlipidemia, diabetes mellitus, family history of coronary artery disease, smoking, hypertension, heart failure, and renal failure. Subgroup analyses were also performed, stratified by age, sex, diabetes, ejection fraction, and history of PCI-S, CABG, or myocardial infarction. A total of 6369 patients (CABG 4581; PCI-S 1788) were included. Age averaged 66+/-10.9 years, 76% were male, and 26% were diabetic. Multivariate risk favored CABG over PCI-S for both death (hazard ratio 0.85; P=0.001) and major adverse cardiovascular events (hazard ratio 0.51; P<0.0001). A similar advantage with CABG was also found in most substrata, including diabetes. CONCLUSIONS: In this large observational study of patients undergoing revascularization for multivessel coronary artery disease, a long-term benefit was found, in relationship to both death and major adverse cardiovascular events, for CABG over PCI-S regardless of diabetic status or other stratifications. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/17846308/Surgical_revascularization_is_associated_with_improved_long_term_outcomes_compared_with_percutaneous_stenting_in_most_subgroups_of_patients_with_multivessel_coronary_artery_disease:_results_from_the_Intermountain_Heart_Registry_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.106.681346?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -