Related Experiment Video
Updated: Mar 12, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Long-term survival after coronary bypass surgery and percutaneous coronary intervention
Per Mølstad1, Rasmus Moer1, Olaf Rødevand1
1Department of cardiology , LHL Clinics Feiring , Feiring , Norway.
Insights
Coronary bypass surgery showed improved survival for three-vessel disease patients in the first 8 years compared to percutaneous coronary intervention. Survival rates were similar for one- and two-vessel disease, and after 8 years for three-vessel disease.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) necessitates effective revascularization strategies.
- Long-term survival differences between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) remain a critical clinical question.
- Optimal treatment selection impacts patient outcomes and healthcare resource allocation.
Purpose of the Study:
- To compare long-term all-cause mortality between CABG and PCI in patients with coronary artery disease.
- To investigate potential differences in survival based on the number of diseased coronary vessels.
- To provide evidence for guiding treatment strategy selection in CAD patients.
Main Methods:
- Retrospective analysis of 22,880 patients from the Feiring Heart Clinic database.
- Patients were treated with either CABG (7,802) or PCI (15,078).
- Survival data were followed for up to 16 years, analyzed using Cox regression and propensity score matching.
Main Results:
- No significant difference in survival was observed between CABG and PCI for one- and two-vessel disease.
- For three-vessel disease, CABG demonstrated a significant survival benefit in the first 8 years (Hazard Ratio: 0.76, 95% CI: 0.69-0.84, p<0.001).
- After 8 years, survival rates became similar for both treatment strategies in three-vessel disease patients.
Conclusions:
- Treatment strategy significantly impacts survival in three-vessel disease, favoring bypass surgery in the initial 8-year period.
- For one- and two-vessel disease, neither CABG nor PCI showed a survival advantage.
- These findings support considering bypass surgery for patients with three-vessel disease, especially within the first 8 years post-intervention.
Objectives:
To assess whether there exists a long-term difference in survival after treatment with coronary bypass surgery or percutaneous coronary intervention in patients with coronary disease as judged by all-cause mortality.
Methods:
Retrospective study from the Feiring Heart Clinic database of survival in 22 880 patients-15 078 treated with percutaneous coronary intervention and 7802 with bypass surgery followed up to 16 years.
Results:
Cox regression and propensity score analysis showed no difference in survival for one-vessel and two-vessel disease during the whole study period. In three-vessel disease, however, the analysis revealed a consistent and highly significant survival benefit in the first 8 years with an HR of 0.76 (95% CI 0.69 to 0.84, p<0.001) in favour of bypass surgery with similar survival rates in the two treatment strategies after that time period.
Conclusions:
Treatment strategy did not affect survival in one-vessel and two-vessel disease, but bypass surgery offered an improved survival in the first 8 years in patients with three-vessel disease. These results are consistent with most previous reports and the survival benefit should be taken into account when selecting a strategy for this patient group.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:27Peripheral Artery Disease III: Interprofessional Care
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:29Cardiomyopathy V: Interprofessional Care