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Br J Med Med Res. 2013 Oct;3(4):1248-1257.

Long-Term Mortality of 306,868 Patients with Multi-Vessel Coronary Artery Disease: CABG versus PCI.

Author information

  • 1East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Departmentof Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Center for Health Disparities Research, Brody School of Medicine, Greenville, NC, USA.
  • 2East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Departmentof Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Departmentof General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
  • 3East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Center for Health Disparities Research, Brody School of Medicine, Greenville, NC, USA.
  • 4Departmentof Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
  • 5Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • 6East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA.

Abstract

BACKGROUND:

Several randomized controlled trials (RCT) have reported no difference in long-term mortality between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The purpose of this pooled observational analysis was to compare recent retrospective studies examining long-term survival of patients with multi-vessel coronary artery disease undergoing CABG and PCI.

METHODOLOGY:

We searched Medline for observational studies comparing long-term (>1 year) survival between CABG and PCI for the treatment of multi-vessel coronary artery disease over the past 10 years.

RESULTS:

Eight studies met inclusion criteria. A total of 306,868 patients (155,502 CABG; 151,366 PCI) were identified. Follow-up ranged from 1 to 8 years. Mantel-Haenszel combined hazard ratios (HR) for mortality demonstrated a protective benefit of CABG compared with PCI (HR=0.77, 95%CI=0.75-0.79).

CONCLUSION:

These findings suggest a long-term survival advantage for CABG compared with PCI in patients with multi-vessel coronary artery disease.

KEYWORDS:

CABG; PCI; long-term; survival

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