Invited Commentary

Abstract

poor prognosis, like malignancy, whereas factors that contraindicate PCI are often lesion-based, such as chronic vessel occlusion, and may have a smaller effect on longterm outcome after CABG. We were not able to quantify frailty and quality of life, which are variables much more complex than mortality and more difficult to measure.In conclusion, this is large registry series of patients with long-term follow-up. At 7 years, CABG was associated with lower rates of cardiac-related mortality, MI, and TVR in patients with LMCA or multivessel disease compared with PCI, and it remains the standard of care, particularly for patients with more complex anatomy.We thank Lois Clegg, an English language teacher at the University of Parma, for her assistance in the revision of the manuscript. References1. Nissinen J, Wistbacka JO, Loponen P, et al. Coronary artery bypass surgery in octogenarians: long-term outcome can be better than expected. Ann Thorac Surg 2010;89:1119-24. 2. Nicolini F, Molardi A, Verdichizzo D, et al. Coronary artery surgery in octogenarians: evolving strategies for the improvement in early and late results. Heart Vessels 2012;27:559-67. 3. McKellar SH, Brown ML, Frye RL, Schaff HV, Sundt TM III. Comparison of coronary revascularization procedures in octogenarians: a systematic review and meta-analysis. Nat Clin Pract Cardiovasc Med 2008;5