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Survival after percutaneous coronary intervention and coronary artery bypass grafting in a single centre

Per Mølstad1

  • 1Feiring Heart Clinic, Feiring, N-2093 Norway. moelsta@online.no

Scandinavian Cardiovascular Journal : SCJ
|August 8, 2007
PubMed

Insights

Coronary artery bypass grafting (CABG) significantly improves survival in patients with three-vessel coronary disease, regardless of diabetes. Percutaneous coronary intervention (PCI) showed no survival benefit in most cases.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery disease (CAD) management involves revascularization strategies like percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).
  • Optimal treatment selection for CAD patients, particularly those with complex disease patterns, remains a critical clinical decision.

Purpose of the Study:

  • To compare the long-term survival rates of patients undergoing PCI versus CABG for coronary artery disease.
  • To evaluate the impact of disease severity (number of diseased vessels) and diabetes on treatment outcomes.

Main Methods:

  • A retrospective analysis of 10,815 patients (6366 PCI, 4449 CABG) treated between March 1999 and December 2005.
  • Survival status was tracked via the Norwegian National Registry up to May 2006.
  • Statistical comparison utilized Cox regression and propensity score analysis to adjust for covariates.

Main Results:

  • Coronary artery bypass grafting (CABG) demonstrated significantly improved survival compared to percutaneous coronary intervention (PCI) in patients with three-vessel disease (hazard ratios 0.40 with diabetes, 0.61 without).
  • A borderline significant survival difference favoring CABG was noted in patients with one/two-vessel disease and diabetes.
  • No significant survival difference was observed between PCI and CABG in patients with one/two-vessel disease without diabetes.

Conclusions:

  • Coronary artery bypass grafting (CABG) appears to offer a survival advantage over percutaneous coronary intervention (PCI) for patients with three-vessel coronary artery disease, including those with diabetes.
  • Treatment strategy decisions should consider the extent of coronary artery disease and patient comorbidities.
Abstract

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