Abstract | OBJECTIVES: METHODS: RESULTS: There were 672 patients undergoing PCI and 392 CABG. Preprocedural left ventricular ejection fraction was not different between PCI and CABG (46.6 ± 15.1 vs 46.6 ± 14.6%, P = 0.89), but the CABG group included more patients with triple-vessel and left main disease (P < 0.01 each). Three-year outcomes revealed that the risk of hospital readmission for heart failure was higher after PCI than after CABG (hazard ratio [95% confidence interval]; 1.90 [1.18-3.05], P = 0.01). More importantly, adjusted mortality after PCI was significantly higher than after CABG (1.79 [1.13-2.82], P = 0.01). The risk of cardiac death after PCI was also higher than after CABG (1.98 [1.10-3.55], P = 0.02). Stratified analysis using the SYNTAX score demonstrated that risk of death was not different between PCI and CABG in patients with low (<23) and intermediate (23-32) SYNTAX scores (2.10 [0.57-7.68], P = 0.26 and 1.43 [0.63-3.21], P = 0.39, respectively), whereas those with a high (≥ 33) SYNTAX score, the risk of death was far higher after PCI than after CABG (4.83 [1.46-16.0], P = 0.01). CONCLUSIONS: In patients with heart failure with advanced coronary artery disease, CABG was a better option than PCI because CABG was associated with better survival benefit, particularly in more complex coronary lesions stratified by the SYNTAX score.
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Authors | Akira Marui, Takeshi Kimura, Noboru Nishiwaki, Tatsuhiko Komiya, Michiya Hanyu, Hiroki Shiomi, Shiro Tanaka, Ryuzo Sakata, CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators |
Journal | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
(Eur J Cardiothorac Surg)
Vol. 47
Issue 2
Pg. 316-21; discussion 321
(Feb 2015)
ISSN: 1873-734X [Electronic] Germany |
PMID | 24662243
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
Topics |
- Aged
- Aged, 80 and over
- Coronary Artery Bypass
(mortality)
- Female
- Follow-Up Studies
- Heart Failure
(epidemiology, surgery)
- Humans
- Japan
(epidemiology)
- Male
- Percutaneous Coronary Intervention
(mortality)
- Ventricular Dysfunction, Left
(surgery)
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