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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

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

PMID:
24440331
DOI:
10.1016/j.amjcard.2013.11.035
[Indexed for MEDLINE]
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