Outcomes of Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention With Drug-Eluting Stents for Patients With Multivessel Coronary Artery Disease

Abstract

Background-Advances in coronary artery bypass grafting (CABG) surgery and percutaneous coronary intervention (PCI) with drug-eluting stents have dramatically improved results of these procedures. The optimal treatment for patients with multivessel coronary artery disease is uncertain given the lack of prospective, randomized data reflecting current practice. This study represents a "real-world" evaluation of current technology in the treatment of multivessel coronary artery disease. Methods and Results-A total of 1680 patients undergoing revascularization for multivessel coronary artery disease were identified. Of these, 1080 patients were treated for 2-vessel disease (196 CABG and 884 PCI) and 600 for 3-vessel disease (505 CABG and 95 PCI). One-year mortality, cerebrovascular events, Q-wave myocardial infarction, target vessel failure, and composite major adverse cardiovascular and cerebrovascular events were compared between the CABG and PCI cohorts. Outcomes were adjusted for baseline covariates and reported as hazard ratios.

Percutaneous Coronary Intervention With Drug-Eluting Stent Implantation vs. Coronary Artery Bypass Grafting for Multivessel Coronary Artery Disease in Metabolic Syndrome Patients With Acute Myocardial Infarction

“…1 In contrast, a recent report showed that in patients with multivessel disease, DES was associated with an increased 1-year mortality rate compared with CABG. 4 In the present study, however, we observed no significant differences in 12-month mortality in metabolic syndrome patients with multivessel disease.…”

Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease

“…[10][11][12] Studies comparing PCI involving drugeluting stents with CABG have generally been smaller and nonrandomized. [13][14][15][16][17][18][19][20][21][22][23][24] Data from randomized, controlled trials of drug-eluting stents as compared with bare-metal stents have shown significant reductions in the rate of repeat intervention, with similar rates of death and myocardial infarction. 25 These improvements have led to expanded use of PCI in patients with complex coronary anatomical features, though most randomized trials comparing drugeluting stents and bare-metal stents excluded such patients.…”

Comparison of bypass surgery and drug-eluting stenting in diabetic patients with left main and/or multivessel disease: A systematic review and meta-analysis of randomized and nonrandomized studies

“…We identified 19 eligible studies (4 randomized [19][20][21][22] and 15 nonrandomized [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]) ( Fig. 1) enrolling 5,805 patients in OCT subgroup (PCI-DES: 2,961; CABG: 2,844) and 3,060 in RCT subgroup (PCI-DES: 1,541; CABG: 1,519), respectively.…”