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Am J Cardiol. 2014 Mar 1;113(5):803-8. doi: 10.1016/j.amjcard.2013.11.035. Epub 2013 Dec 12.

Comparison of intermediate-term outcomes of coronary artery bypass grafting versus drug-eluting stents for patients ≥75 years of age.

Author information

  • 1University at Albany, State University of New York, Albany, New York. Electronic address: elh03@health.state.ny.us.
  • 2University at Albany, State University of New York, Albany, New York.
  • 3Geisinger Medical Center, Danville, Pennsylvania.
  • 4Johns Hopkins University, Baltimore, Maryland.
  • 5Yale School of Medicine, New Haven, Connecticut.
  • 6Penn State Hershey College of Medicine, Hershey, Pennsylvania.
  • 7Albany Medical Center, Albany, New York.
  • 8The Ohio State University, Columbus, Ohio.
  • 9Columbia-Presbyterian Medical Center, New York, New York.
  • 10University of Connecticut Health Center, Storrs, Connecticut.
  • 11St. Joseph's Health System, Atlanta, Georgia.

Abstract

Several randomized controlled trials and observational studies have compared outcomes of percutaneous coronary interventions (PCIs) with drug-eluting stents (DESs) and coronary artery bypass grafting (CABG), but they have not thoroughly investigated the relative difference in outcomes for patients aged ≥75 years. In this study, a total of 3,864 patients receiving DES and CABG (1,932 CABG-DES pairs) with multivessel coronary disease were propensity matched using multiple patient risk factors and were compared with respect to 3 outcomes (mortality, stroke/myocardial infarction [MI]/mortality, and repeat revascularization) at 2.5 years with a mean follow-up of 18 months. The mortality rates (DES/CABG hazard ratio 1.06, 95% confidence interval 0.87 to 1.30) and the stroke/MI/mortality rates (DES/CABG hazard ratio 1.15, 95% confidence interval 0.97 to 1.38) for the 2 procedures were not significantly different. Repeat revascularization rates were significantly higher for patients who received DESs. In conclusion, older patients experienced similar mortality and stroke/MI/mortality rates for CABG and PCI with DES, although repeat revascularization rates were higher for patients undergoing PCI with DES.

Copyright © 2014 Elsevier Inc. All rights reserved.

PMID:
24440331
[PubMed - indexed for MEDLINE]
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