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Comparison of drug-eluting stents and coronary artery bypass surgery for the treatment of multivessel coronary disease: three-year follow-up results from a single institution.
Circulation. 2009 Apr 21; 119(15):2040-50.Circ

Abstract

BACKGROUND

Numerous studies have compared the outcomes of coronary artery bypass grafting (CABG) surgery and coronary stenting for the treatment of multivessel coronary disease. In 2003, drug-eluting stents were introduced with the hope of reducing restenosis. However, limited information exists on the comparison of drug-eluting stents and CABG surgery. The long-term outcome of drug-eluting stents compared with that of CABG surgery is also unclear.

METHODS AND RESULTS

We identified 3720 consecutive patients with multivessel disease who underwent isolated CABG surgery or received drug-eluting stents between April 1, 2004, and December 31, 2005, and we compared safety (total mortality, myocardial infarction, and stroke) and efficacy (target-vessel revascularization) during a 3-year follow-up. These outcomes were compared after adjustment for differences in baseline risk factors. Patients who underwent CABG (n=1886) were older and had more comorbidities than patients who received drug-eluting stents (n=1834). Patients receiving drug-eluting stents had considerably higher 3-year rates of target-vessel revascularization. Drug-eluting stents were also associated with higher rates of death (adjusted hazard ratio, 1.62; 95% confidence interval, 1.07 to 2.47) and myocardial infarction (adjusted hazard ratio, 1.65; 95% confidence interval, 1.15 to 2.44). The risk adjusted rate of stroke was similar in the 2 groups (hazard ratio, 0.92; 95% confidence interval, 0.69 to 1.51).

CONCLUSIONS

In a cohort of patients with multivessel disease, CABG was associated with lower rates of death, myocardial infarction, and target-vessel revascularization than drug-eluting stents.

Authors+Show Affiliations

Department of Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.No 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

19349321

Citation

Li, Yan, et al. "Comparison of Drug-eluting Stents and Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Disease: Three-year Follow-up Results From a Single Institution." Circulation, vol. 119, no. 15, 2009, pp. 2040-50.
Li Y, Zheng Z, Xu B, et al. Comparison of drug-eluting stents and coronary artery bypass surgery for the treatment of multivessel coronary disease: three-year follow-up results from a single institution. Circulation. 2009;119(15):2040-50.
Li, Y., Zheng, Z., Xu, B., Zhang, S., Li, W., Gao, R., & Hu, S. (2009). Comparison of drug-eluting stents and coronary artery bypass surgery for the treatment of multivessel coronary disease: three-year follow-up results from a single institution. Circulation, 119(15), 2040-50. https://doi.org/10.1161/CIRCULATIONAHA.108.819730
Li Y, et al. Comparison of Drug-eluting Stents and Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Disease: Three-year Follow-up Results From a Single Institution. Circulation. 2009 Apr 21;119(15):2040-50. PubMed PMID: 19349321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of drug-eluting stents and coronary artery bypass surgery for the treatment of multivessel coronary disease: three-year follow-up results from a single institution. AU - Li,Yan, AU - Zheng,Zhe, AU - Xu,Bo, AU - Zhang,Shiju, AU - Li,Wei, AU - Gao,Runlin, AU - Hu,Shengshou, Y1 - 2009/04/06/ PY - 2009/4/8/entrez PY - 2009/4/8/pubmed PY - 2009/5/9/medline SP - 2040 EP - 50 JF - Circulation JO - Circulation VL - 119 IS - 15 N2 - BACKGROUND: Numerous studies have compared the outcomes of coronary artery bypass grafting (CABG) surgery and coronary stenting for the treatment of multivessel coronary disease. In 2003, drug-eluting stents were introduced with the hope of reducing restenosis. However, limited information exists on the comparison of drug-eluting stents and CABG surgery. The long-term outcome of drug-eluting stents compared with that of CABG surgery is also unclear. METHODS AND RESULTS: We identified 3720 consecutive patients with multivessel disease who underwent isolated CABG surgery or received drug-eluting stents between April 1, 2004, and December 31, 2005, and we compared safety (total mortality, myocardial infarction, and stroke) and efficacy (target-vessel revascularization) during a 3-year follow-up. These outcomes were compared after adjustment for differences in baseline risk factors. Patients who underwent CABG (n=1886) were older and had more comorbidities than patients who received drug-eluting stents (n=1834). Patients receiving drug-eluting stents had considerably higher 3-year rates of target-vessel revascularization. Drug-eluting stents were also associated with higher rates of death (adjusted hazard ratio, 1.62; 95% confidence interval, 1.07 to 2.47) and myocardial infarction (adjusted hazard ratio, 1.65; 95% confidence interval, 1.15 to 2.44). The risk adjusted rate of stroke was similar in the 2 groups (hazard ratio, 0.92; 95% confidence interval, 0.69 to 1.51). CONCLUSIONS: In a cohort of patients with multivessel disease, CABG was associated with lower rates of death, myocardial infarction, and target-vessel revascularization than drug-eluting stents. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/19349321/Comparison_of_drug_eluting_stents_and_coronary_artery_bypass_surgery_for_the_treatment_of_multivessel_coronary_disease:_three_year_follow_up_results_from_a_single_institution_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.108.819730?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -