TY - JOUR
T1 - Long-term mortality of coronary artery bypass grafting and bare-metal stenting
AU - Wu, Chuntao
AU - Zhao, Songyang
AU - Wechsler, Andrew S.
AU - Lahey, Stephen
AU - Walford, Gary
AU - Culliford, Alfred T.
AU - Gold, Jeffrey P.
AU - Smith, Craig R.
AU - Holmes, David R.
AU - King, Spencer B.
AU - Higgins, Robert S.D.
AU - Jordan, Desmond
AU - Hannan, Edward L.
N1 - Funding Information:
This work was supported by the National Institutes of Health ( RC1HL099122 ). We thank the New York State Cardiac Advisory Committee for their encouragement and support of this study and Kimberly Cozzens, Cynthia Johnson, Rosemary Lombardo, and the cardiac catheterization laboratories and cardiac surgery programs of the participating hospitals for their tireless efforts to ensure the timeliness, completeness, and accuracy of the registry data.
PY - 2011/12
Y1 - 2011/12
N2 - 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.
AB - 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.
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U2 - 10.1016/j.athoracsur.2011.06.061
DO - 10.1016/j.athoracsur.2011.06.061
M3 - Article
C2 - 22014747
AN - SCOPUS:81855213187
SN - 0003-4975
VL - 92
SP - 2132
EP - 2138
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -