Document Detail


Comparison of 30-Day and 5-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients Aged ≤50 Years (the Coronary aRtery diseAse in younG adultS Study).
MedLine Citation:
PMID:  24878127     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Data on the outcome of young patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are scarce. Data on 2,209 consecutive patients aged ≤50 years who underwent CABG or PCI were retrospectively collected from 15 European institutions. PCI and CABG had similar 30-day mortality rates (0.8% vs 1.4%, p = 0.27), late survival (at 5 years, 97.8% vs 94.9%, p = 0.082), and freedom from stroke (at 5 years, 98.0% and 98.0%, p = 0.731). PCI was associated with significantly lower freedom from major adverse cardiac and cerebrovascular events (at 5 years, 73.9% vs 85.0%, p <0.0001), repeat revascularization (at 5 years, 77.6% vs 92.5%, p <0.0001), and myocardial infarction (at 5 years, 89.9% vs 96.6%, p <0.0001) compared with CABG. These findings were confirmed in propensity score-adjusted and matched analyses. Freedom from major adverse cardiac and cerebrovascular events after PCI was particularly low in diabetics (at 5 years, 58.0% vs 75.9%, p <0.0001) and in patients with multivessel disease (at 5 years, 63.6% vs 85.1%, p <0.0001). PCI in patients with ST elevation myocardial infarction was associated with significantly better 5-year survival (97.5% vs 88.8%, p = 0.001), which was driven by its lower 30-day mortality rate (1.5% vs 6.0%, p = 0.017). In conclusion, patients aged ≤50 years have an excellent immediate outcome after either PCI or CABG with similar long-term survival when used according to the current clinical practice. PCI was associated with significantly lower freedom from myocardial infarction and repeat revascularization.
Authors:
Fausto Biancari; Tomas Gudbjartsson; Jouni Heikkinen; Vesa Anttila; Timo Mäkikallio; Anders Jeppsson; Linda Thimour-Bergström; Carmelo Mignosa; Antonino S Rubino; Kari Kuttila; Jarmo Gunn; Jan-Ola Wistbacka; Kari Teittinen; Kari Korpilahti; Francesco Onorati; Giuseppe Faggian; Giulia Vinco; Corrado Vassanelli; Flavio Ribichini; Tatu Juvonen; Tomas A Axelsson; Axel F Sigurdsson; Pasi P Karjalainen; Ari Mennander; Olli Kajander; Markku Eskola; Erkki Ilveskoski; Veronica D'Oria; Marisa De Feo; Tuomas Kiviniemi; K E Juhani Airaksinen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-2
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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