One-year outcomes of coronary artery bypass graft surgery versus percutaneous coronary intervention with multiple stenting for multisystem disease: A meta-analysis of individual patient data from randomized clinical trials

Abstract

One year after the initial procedure, percutaneous coronary intervention with multiple stenting and coronary artery bypass graft surgery provided a similar degree of protection against death, myocardial infarction, or stroke for patients with multisystem disease. Repeat revascularization procedures remain high after percutaneous coronary intervention, but the difference with coronary artery bypass graft surgery has narrowed in the era of stenting.

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

“…Thus patients underwent concomitant treatment of multiple vessels during the same hospitalization. The good results in the present series are to be noted in the case of complete revascularization in patients with multivessel coronary artery disease, compared to results reported for surgery or PCI alone [19,20,21]. Compared to other hybrid revascularization series involving right coronary stenting [22,23,24], our follow-up results were very satisfactory.…”

Pharmacological Treatment and Perceived Health Status During 1-Year Follow Up in Patients Diagnosed with Coronary Artery Disease, But Ineligible for Revascularization: Results from the Euro Heart Survey on Coronary Revascularization

“…Treatment of patients with CAD includes risk factor management, drug therapy and revascularization techniques. In addition to drug therapy, mechanical revascularizations by means of coronary-artery bypass grafting (CABG) or, more increasingly [3] percutaneous coronary interventions (PCI) can be offered to relieve symptoms and improve quality of life and prognosis [4][5][6]. However, in recent years it has been recognized that there is a group of patients in whom revascularization is no option [7].…”

Status of percutaneous coronary intervention and coronary artery bypass

“…Risk-adjusted survival was greater for CAB than for stent placement in all anatomic subgroups studied at 3 years. Revascularization was required in 35.1% after stenting and 4.9% after CAB with the former being nearly twice that reported in the RCT's above [7,10].…”

“…Although subsequent revascularization was more frequent after stenting, it was almost 50% less than observed in RCT's of BA and CAB [7]. Meta-analysis of individual patient data from four RCT's, which provides more reliable treatment effect estimates, gave similar results [10].…”