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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

Current clinical outcomes of percutaneous coronary intervention and coronary artery bypass grafting

Michael J Mack1, Syma L Prince, Morley Herbert

  • 1Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA. slhill@csant.com

The Annals of Thoracic Surgery
|July 22, 2008
PubMed

Insights

Coronary artery bypass grafting (CABG) showed lower repeat revascularization rates than percutaneous coronary intervention (PCI). However, major adverse cardiac events, mortality, and myocardial infarction were similar between CABG and PCI.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Previous randomized trials comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) may not reflect current practices with drug-eluting stents (DES) and off-pump CABG.
  • A prospective registry was established to compare clinical outcomes of contemporary CABG and PCI strategies.

Purpose of the Study:

  • To compare clinical outcomes of coronary revascularization using on-pump CABG, off-pump CABG, and PCI with or without DES.
  • To evaluate rates of major adverse cardiac events, repeat revascularization, and event-free survival at 18 months.

Main Methods:

  • Prospective registry of 4336 patients undergoing isolated coronary revascularization across 8 community hospitals.
  • Data collection included preprocedural, intraprocedural, and postprocedural variables.
  • Outcomes were assessed at 18 months via patient/physician contact and the Social Security Death Index.

Main Results:

  • Major adverse cardiac events occurred in 14.7% of CABG patients versus 23.3% of PCI patients (p < 0.001).
  • Repeat revascularization was significantly lower with CABG (6.2%) compared to PCI (13.6%) (p < 0.001).
  • Mortality and myocardial infarction rates were similar; event-free survival was higher for CABG (85.3%) than PCI (76.8%) (p < 0.001).

Conclusions:

  • CABG is associated with significantly lower rates of repeat revascularization compared to PCI.
  • No significant differences were observed in mortality or myocardial infarction rates between CABG and PCI.
  • Outcomes were comparable between on-pump and off-pump CABG, and between DES and bare-metal stents (BMS) in PCI.
Abstract

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