Document Detail

Long-term mortality of coronary artery bypass grafting and bare-metal stenting.
MedLine Citation:
PMID:  22014747     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is little information on relative survival with follow-up longer than 5 years in patients undergoing coronary artery bypass grafting (CABG) and patients undergoing percutaneous coronary intervention (PCI) with stenting. This study tested the hypothesis that CABG is associated with a lower risk of long-term (8-year) mortality than is stenting with bare-metal stents for multivessel coronary disease.
METHODS: We identified 18,359 patients with multivessel disease who underwent isolated CABG and 13,377 patients who received bare-metal stenting in 1999 to 2000 in New York and followed their vital status through 2007 using the National Death Index (NDI). We matched CABG and stent patients on the number of diseased coronary vessels, proximal left anterior descending (LAD) artery disease, and propensity of undergoing CABG based on numerous patient characteristics and compared survival after the 2 procedures.
RESULTS: In the 7,235 pairs of matched patients, the overall 8-year survival rates were 78.0% for CABG and 71.2% for stenting (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.64 to 0.74; p < 0.001). For anatomic groups classified by the number of diseased vessels and proximal LAD involvement, the HRs ranged from 0.53 (p < 0.001) for patients with 3-vessel disease involving proximal LAD artery disease to 0.78 (p = 0.05) for patients with 2-vessel disease but no disease in the LAD artery. A lower risk of death after CABG was observed in all subgroups stratified by a number of baseline risk factors.
CONCLUSIONS: Coronary artery bypass grafting is associated with a lower risk of death than is stenting with bare metal stents for multivessel coronary disease.
Chuntao Wu; Songyang Zhao; Andrew S Wechsler; Stephen Lahey; Gary Walford; Alfred T Culliford; Jeffrey P Gold; Craig R Smith; David R Holmes; Spencer B King; Robert S D Higgins; Desmond Jordan; Edward L Hannan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-10-19
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  92     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-25     Completed Date:  2012-01-17     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2132-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, Pennsylvania 17033, USA.
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MeSH Terms
Angioplasty, Balloon, Coronary / mortality*
Coronary Artery Bypass / mortality*
Middle Aged
Survival Rate
Grant Support
Comment In:
Ann Thorac Surg. 2011 Dec;92(6):2138-9   [PMID:  22115226 ]

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