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Five-year outcomes in patients with multivessel coronary artery disease undergoing surgery or percutaneous

Szymon Jonik1, Shigetaka Kageyama2, Kai Ninomiya2

  • 11st Department of Cardiology, Medical University of Warsaw, Banacha 1a Str, 01-267, Warsaw, Poland. szymonjonik.wum@gmail.com.

Scientific Reports
|February 8, 2024
PubMed

Insights

For severe coronary artery disease, both coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) show similar long-term survival. CABG reduces repeat revascularization, while PCI is associated with fewer strokes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Optimal revascularization strategy for multivessel coronary artery disease (MVD) remains under investigation.
  • Real-world evidence on long-term outcomes comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) is limited.

Purpose of the Study:

  • To compare 5-year clinical outcomes and quality of life in patients with severe coronary artery disease (CAD) treated with CABG versus PCI.
  • To evaluate the effectiveness of different revascularization strategies in a real-life clinical setting.

Main Methods:

  • Retrospective analysis of 1035 patients with severe CAD.
  • Patients were treated with either CABG (356) or PCI (679) based on Heart Team recommendations.
  • Assessment of 5-year primary and secondary endpoints, including mortality, myocardial infarction (MI), major adverse cardiac and cerebrovascular events (MACCE), repeat revascularization (RR), and stroke.

Main Results:

  • No significant difference in overall mortality or MI rates between CABG and PCI at 5 years.
  • Higher rates of MACCE and RR in the PCI group compared to the CABG group (P < 0.01).
  • CABG group experienced a higher incidence of stroke compared to the PCI group (P < 0.01).

Conclusions:

  • In real-world practice, neither CABG nor PCI demonstrates overwhelming superiority for severe CAD at 5-year follow-up.
  • Mortality and MI rates are comparable; CABG is associated with lower RR, whereas PCI is linked to fewer strokes.

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