- In real-world patients with multivessel coronary artery disease (CAD) treated with either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with newer generation stents, the intermediate-term survival benefit was higher with CABG to that with PCI.
Why this matters
- Findings suggest that in real-world patients with multivessel disease (MVD), CABG should be the preferred revascularisation modality.
- 6383 patients with MVD undergoing CABG (n=4230; mean age, 66.4±10 years) or PCI (n=2153; mean age, 65.3±12.1 years) with second/third generation drug-eluting stents were included.
- Mean follow-up period: 3.3 years.
- Primary outcome: all-cause mortality.
- Funding: None disclosed.
- 5-year estimated survival was higher among patients who had CABG vs PCI (88% vs 78.3%; Plog-rank <.001>
- CABG vs PCI was associated with significantly more in-hospital cerebral vascular accidents (1.1% vs 0.2%; P<.001>
- The crude HR for PCI over CABG was 1.73 (95% CI, 1.49-2.01; P<.001 and the adjusted hr was ci p>
- After adjustment, mortality rate was higher with PCI in patients with no previous CABG and stable CAD (HR, 2.11; 95% CI, 1.49-3.00; P<.001>
- After propensity matching (CABG, n=653; PCI, n=653), PCI was associated with a higher adjusted HR for all-cause mortality (2.18; 95% CI, 1.54-3.1; P<.001>
- Selection bias.
- Retrospective design and non-randomised nature of the study.