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Stents versus bypass surgery: 3-year mortality risk of patients with coronary interventions aged 50+ in Germany

Sophia Nestler1, Daniel Kreft2,3, Peter Donndorf4

  • 1Institute of Sociology and Demography, University of Rostock, Ulmenstraße 69, 18057, Rostock, Germany.

Journal of Cardiothoracic Surgery
|October 1, 2022
PubMed

Insights

Coronary artery disease interventions like drug-eluting stents (DES) and coronary artery bypass grafting (CABG) show lower mortality risks compared to bare-metal stents (BMS). These findings aid in assessing risks for cardiac procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Public Health

Background:

  • Coronary artery disease (CAD) prevalence is rising due to aging populations.
  • This increases demand for interventions like stenting and bypass surgery.
  • Comparative mortality risk of different CAD interventions requires investigation.

Purpose of the Study:

  • To investigate the mortality risk associated with coronary artery bypass grafting (CABG), bare-metal stents (BMS), and drug-eluting stents (DES).
  • To compare the long-term survival outcomes of these major CAD interventions.

Main Methods:

  • Analysis of a random sample of 250,000 health insurance members in Germany (2004-2015).
  • Utilized Cox Proportional-Hazard models for incident coronary artery disease (CAD) patients.
  • Risk adjustment for demographic and clinical factors; 3-year mortality follow-up for DES.

Main Results:

  • Bare-metal stents (BMS) were the most frequent procedure (48%).
  • Drug-eluting stents (DES) and coronary artery bypass grafting (CABG) showed similar intervention proportions (23% and 19%, respectively).
  • After risk adjustment, DES and CABG demonstrated a significantly lower mortality risk (21% reduction, p<0.01) compared to BMS.

Conclusions:

  • Both CABG and DES interventions offer survival advantages over BMS for CAD patients.
  • No significant difference in mortality risk was observed between DES and CABG groups.
  • Further research should consider quality of life, rehabilitation, and cost-effectiveness.
Abstract

Keywords:
Coronary artery bypassCoronary artery diseaseFollow-upHealth claims dataMortalityStents

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