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Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease.
Circulation. 2008 Apr 22; 117(16):2079-86.Circ

Abstract

BACKGROUND

Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated.

METHODS AND RESULTS

Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0% for CABG versus 4.4% for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95% confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95% CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95% CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95% CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95% CI, 2.11 to 3.75; P<0.001).

CONCLUSIONS

For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG.

Authors+Show Affiliations

Division of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.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 available

Pub Type(s)

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

Language

eng

PubMed ID

18413495

Citation

Park, Duk-Woo, et al. "Long-term Mortality After Percutaneous Coronary Intervention With Drug-eluting Stent Implantation Versus Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Artery Disease." Circulation, vol. 117, no. 16, 2008, pp. 2079-86.
Park DW, Yun SC, Lee SW, et al. Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease. Circulation. 2008;117(16):2079-86.
Park, D. W., Yun, S. C., Lee, S. W., Kim, Y. H., Lee, C. W., Hong, M. K., Kim, J. J., Choo, S. J., Song, H., Chung, C. H., Lee, J. W., Park, S. W., & Park, S. J. (2008). Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease. Circulation, 117(16), 2079-86. https://doi.org/10.1161/CIRCULATIONAHA.107.750109
Park DW, et al. Long-term Mortality After Percutaneous Coronary Intervention With Drug-eluting Stent Implantation Versus Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Artery Disease. Circulation. 2008 Apr 22;117(16):2079-86. PubMed PMID: 18413495.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease. AU - Park,Duk-Woo, AU - Yun,Sung-Cheol, AU - Lee,Seung-Whan, AU - Kim,Young-Hak, AU - Lee,Cheol Whan, AU - Hong,Myeong-Ki, AU - Kim,Jae-Joong, AU - Choo,Suk Jung, AU - Song,Hyun, AU - Chung,Cheol Hyun, AU - Lee,Jae-Won, AU - Park,Seong-Wook, AU - Park,Seung-Jung, Y1 - 2008/04/14/ PY - 2008/4/17/pubmed PY - 2008/5/16/medline PY - 2008/4/17/entrez SP - 2079 EP - 86 JF - Circulation JO - Circulation VL - 117 IS - 16 N2 - BACKGROUND: Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated. METHODS AND RESULTS: Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0% for CABG versus 4.4% for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95% confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95% CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95% CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95% CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95% CI, 2.11 to 3.75; P<0.001). CONCLUSIONS: For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/18413495/Long_term_mortality_after_percutaneous_coronary_intervention_with_drug_eluting_stent_implantation_versus_coronary_artery_bypass_surgery_for_the_treatment_of_multivessel_coronary_artery_disease_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.750109?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -