Naslov (eng)

Single or multiple arterial bypass graft surgery vs. percutaneous coronary intervention in patients with three-vessel or left main coronary artery disease

Autor

Davierwala, Piroze
Gao, Chao
Thuijs, Daniel J.F.M.
Wang, Rutao
Hara, Hironori
Ono, Masafumi
Noack, Thilo
Garg, Scot
O’leary, Neil
Milojević, Milan
Kappetein, Arie Pieter
Morice, Marie-Claude
Mack, Michael J.
Van Geuns, Robert-Jan
Holmes Jr., David R.
Gaudino, Mario
Taggart, David P.
Onuma, Yoshinobu
Mohr, Friedrich Wilhelm
Serruys, Patrick W.

Doprinosi

SYNTAX Extended Survival Investigators

Opis (eng)

AIM: The aim of this study was to compare long-term all-cause mortality between patients receiving percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) using multiple (MAG) or single arterial grafting (SAG). METHODS AND RESULTS: The current study is a post hoc analysis of the SYNTAX Extended Survival Study, which compared PCI with CABG in patients with three-vessel (3VD) and/or left main coronary artery disease (LMCAD) and evaluated survival with >_10 years of follow-up. The primary endpoint was all-cause mortality at maximum follow-up (median 11.9 years) assessed in the as-treated population. Of the 1743 patients, 901 (51.7%) underwent PCI, 532 (30.5%) received SAG, and 310 (17.8%) had MAG. At maximum follow-up, all-cause death occurred in 305 (33.9%), 175 (32.9%), and 70 (22.6%) patients in the PCI, SAG, and MAG groups, respectively (P < 0.001). Multiple arterial grafting [adjusted hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.49–0.89], but not SAG (adjusted HR 0.83, 95% CI 0.67–1.03), was associated with significantly lower all-cause mortality compared with PCI. In patients with 3VD, both MAG (adjusted HR 0.55, 95% CI 0.37–0.81) and SAG (adjusted HR 0.68, 95% CI 0.50–0.91) were associated with significantly lower mortality than PCI, whereas in LMCAD patients, no significant differences between PCI and MAG (adjusted HR 0.90, 95% CI 0.56–1.46) or SAG (adjusted HR 1.11, 95% CI 0.81–1.53) were observed. In patients with revascularization of all three major myocardial territories, a positive correlation was observed be- tween the number of myocardial territories receiving arterial grafts and survival (Ptrend = 0.003). CONCLUSION: Our findings suggest that MAG might be the more desirable configuration for CABG to achieve lower long-term all-cause mortality than PCI in patients with 3VD and/or LMCAD. TRIAL REGISTRATION: Registered on clinicaltrial.gov. SYNTAXES: NCT03417050 (https://clinicaltrials.gov/ct2/show/NCT03417050); SYNTAX: NCT00114972 (https://www.clinicaltrials.gov/ct2/show/NCT00114972).

Jezik

engleski

Datum

2022

Licenca

Ovo delo je licencirano pod uslovima licence
Creative Commons CC BY-NC 4.0 - Creative Commons Autorstvo - Nekomercijalno 4.0 International License.

http://creativecommons.org/licenses/by-nc/4.0/legalcode

Predmet

Key words: percutaneous coronary intervention, coronary artery bypass grafting, multiple arterial grafting, single arterial grafting

Deo kolekcije (1)

o:2793

Radovi saradnika Instituta za kardiovaskularne bolesti "Dedinje"