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Author Spotlight: Enhancing Coronary Artery Revascularization
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Survival difference between coronary bypass surgery and percutaneous coronary intervention

Per Mølstad1

  • 1Department of cardiology, LHL-Clinics Feiring , Feiring , Norway.

Scandinavian Cardiovascular Journal : SCJ
|April 29, 2015
PubMed

Insights

Coronary artery bypass surgery shows persistently lower death rates than percutaneous coronary intervention in three-vessel disease patients. This finding suggests bypass surgery remains the standard treatment for these individuals.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Health Outcomes Research

Background:

  • Coronary artery bypass surgery (CABS) has historically shown survival benefits over percutaneous coronary intervention (PCI) in certain coronary artery disease (CAD) subsets.
  • Recent trends in revascularization strategies warrant an updated assessment of these outcomes.

Purpose of the Study:

  • To determine if the survival advantage of CABS over PCI in specific CAD patient groups persists in contemporary practice.
  • To compare outcomes between two distinct treatment periods: 1999-2005 and 2006-2011.

Main Methods:

  • Retrospective analysis of 17,739 patients undergoing coronary revascularization at Feiring Heart Clinic.
  • Survival data were analyzed using Cox regression and propensity score matching for two distinct time cohorts.
  • Follow-up duration was 5 years post-procedure.

Main Results:

  • No significant survival difference was observed between CABS and PCI for one- and two-vessel disease in either time period.
  • In three-vessel disease, CABS demonstrated a persistent survival benefit over PCI, with hazard ratios of 0.62 and 0.59 in the respective time periods (p < 0.001).
  • These results indicate a consistent advantage for bypass surgery in complex multivessel disease.

Conclusions:

  • The superior survival rates associated with coronary artery bypass surgery compared to percutaneous coronary intervention in three-vessel disease patients are sustained in recent years.
  • Coronary artery bypass surgery should continue to be considered the standard of care for patients with three-vessel coronary artery disease.
Abstract

Keywords:
coronary bypass surgerypercutaneous coronary interventionsurvival

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