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Long-term outcomes of coronary-artery bypass graft surgery versus percutaneous coronary intervention for multivessel coronary artery disease in the bare-metal stent era.
Circulation 2008; 118(14 Suppl):S199-209Circ

Abstract

BACKGROUND

Observational registries comparing coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI) have reported long-term survival results that are discordant with those of randomized trials.

METHODS AND RESULTS

We conducted a multicenter study in Japan enrolling consecutive patients undergoing first CABG or PCI between January 2000 and December 2002. Among 9877 patients enrolled, 5420 (PCI: 3712, CABG: 1708) had multivessel disease without left main involvement. Because age is an important determinant when choosing revascularization strategies, survival analysis was stratified by either age >/=75 or <75 years. Analyses were also performed in other relevant subgroups. Median follow-up interval was 1284 days with 95% follow-up rate at 2 years. At 3 years, unadjusted survival rates were 91.7% and 89.6% in the CABG and PCI groups, respectively (log rank P=0.26). After adjustment for baseline characteristics, survival outcome tended to be better after CABG (hazard ratio for death after PCI versus CABG [HR], 95% confidence interval [CI]: 1.23 [0.99-1.53], P=0.06). Adjusted survival outcomes also tended to be better for CABG among elderly patients (HR [95%CI]: 1.37 [0.98-1.92] P=0.07), but not among nonelderly patients (HR [95% CI]: 1.09 [0.82-1.46], P=0.55). Unadjusted and adjusted survival outcome for CABG and PCI were not significantly different in any subgroups when elderly patients were excluded from analysis.

CONCLUSIONS

In the CREDO-Kyoto registry, survival outcomes among patients <75 years of age were similar after PCI and CABG, a result that is consistent with those of randomized trials.

Authors+Show Affiliations

Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 Japan. taketaka@kuhp.kyoto-u.ac.jpNo 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 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
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18824755

Citation

Kimura, Takeshi, et al. "Long-term Outcomes of Coronary-artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-metal Stent Era." Circulation, vol. 118, no. 14 Suppl, 2008, pp. S199-209.
Kimura T, Morimoto T, Furukawa Y, et al. Long-term outcomes of coronary-artery bypass graft surgery versus percutaneous coronary intervention for multivessel coronary artery disease in the bare-metal stent era. Circulation. 2008;118(14 Suppl):S199-209.
Kimura, T., Morimoto, T., Furukawa, Y., Nakagawa, Y., Shizuta, S., Ehara, N., ... Kita, T. (2008). Long-term outcomes of coronary-artery bypass graft surgery versus percutaneous coronary intervention for multivessel coronary artery disease in the bare-metal stent era. Circulation, 118(14 Suppl), pp. S199-209. doi:10.1161/CIRCULATIONAHA.107.735902.
Kimura T, et al. Long-term Outcomes of Coronary-artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-metal Stent Era. Circulation. 2008 Sep 30;118(14 Suppl):S199-209. PubMed PMID: 18824755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of coronary-artery bypass graft surgery versus percutaneous coronary intervention for multivessel coronary artery disease in the bare-metal stent era. AU - Kimura,Takeshi, AU - Morimoto,Takeshi, AU - Furukawa,Yutaka, AU - Nakagawa,Yoshihisa, AU - Shizuta,Satoshi, AU - Ehara,Natsuhiko, AU - Taniguchi,Ryoji, AU - Doi,Takahiro, AU - Nishiyama,Kei, AU - Ozasa,Neiko, AU - Saito,Naritatsu, AU - Hoshino,Kozo, AU - Mitsuoka,Hirokazu, AU - Abe,Mitsuru, AU - Toma,Masanao, AU - Tamura,Toshihiro, AU - Haruna,Yoshisumi, AU - Imai,Yukiko, AU - Teramukai,Satoshi, AU - Fukushima,Masanori, AU - Kita,Toru, PY - 2008/10/10/pubmed PY - 2008/10/24/medline PY - 2008/10/10/entrez SP - S199 EP - 209 JF - Circulation JO - Circulation VL - 118 IS - 14 Suppl N2 - BACKGROUND: Observational registries comparing coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI) have reported long-term survival results that are discordant with those of randomized trials. METHODS AND RESULTS: We conducted a multicenter study in Japan enrolling consecutive patients undergoing first CABG or PCI between January 2000 and December 2002. Among 9877 patients enrolled, 5420 (PCI: 3712, CABG: 1708) had multivessel disease without left main involvement. Because age is an important determinant when choosing revascularization strategies, survival analysis was stratified by either age >/=75 or <75 years. Analyses were also performed in other relevant subgroups. Median follow-up interval was 1284 days with 95% follow-up rate at 2 years. At 3 years, unadjusted survival rates were 91.7% and 89.6% in the CABG and PCI groups, respectively (log rank P=0.26). After adjustment for baseline characteristics, survival outcome tended to be better after CABG (hazard ratio for death after PCI versus CABG [HR], 95% confidence interval [CI]: 1.23 [0.99-1.53], P=0.06). Adjusted survival outcomes also tended to be better for CABG among elderly patients (HR [95%CI]: 1.37 [0.98-1.92] P=0.07), but not among nonelderly patients (HR [95% CI]: 1.09 [0.82-1.46], P=0.55). Unadjusted and adjusted survival outcome for CABG and PCI were not significantly different in any subgroups when elderly patients were excluded from analysis. CONCLUSIONS: In the CREDO-Kyoto registry, survival outcomes among patients <75 years of age were similar after PCI and CABG, a result that is consistent with those of randomized trials. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/18824755/Long_term_outcomes_of_coronary_artery_bypass_graft_surgery_versus_percutaneous_coronary_intervention_for_multivessel_coronary_artery_disease_in_the_bare_metal_stent_era_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.735902?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -