Per Mølstad1. 1. Department of cardiology, LHL-Clinics Feiring , Feiring , Norway.
Abstract
OBJECTIVES: To assess whether the previously observed lower death rate with coronary artery bypass surgery compared with percutaneous coronary intervention in subsets of patients with coronary artery disease persists in more recent years. DESIGN: Retrospective study from Feiring Heart Clinic database of survival in 17739 patients followed for 5 years after coronary revascularization. The cohorts treated in 1999-2005 and 2006-2011 were compared using Cox regression and propensity score analyses. RESULTS: Cox regression and propensity score analyses revealed no difference in survival in either time period in one- and two-vessel diseases. In three-vessel disease, the hazard ratios between bypass surgery and percutaneous intervention were 0.62 (95% confidence interval [CI]: 0.53-0.71, p < 0.001) and 0.59 (95% CI: 0.47-0.73, p < 0.001), respectively, in the two time periods, indicating persistent higher survival with bypass surgery. CONCLUSIONS: The previously observed lower death rate of coronary artery bypass surgery compared with percutaneous intervention in patients with three-vessel disease is persistent in more recent years and indicates that bypass surgery still should be the standard treatment for these patients.
OBJECTIVES: To assess whether the previously observed lower death rate with coronary artery bypass surgery compared with percutaneous coronary intervention in subsets of patients with coronary artery disease persists in more recent years. DESIGN: Retrospective study from Feiring Heart Clinic database of survival in 17739 patients followed for 5 years after coronary revascularization. The cohorts treated in 1999-2005 and 2006-2011 were compared using Cox regression and propensity score analyses. RESULTS: Cox regression and propensity score analyses revealed no difference in survival in either time period in one- and two-vessel diseases. In three-vessel disease, the hazard ratios between bypass surgery and percutaneous intervention were 0.62 (95% confidence interval [CI]: 0.53-0.71, p < 0.001) and 0.59 (95% CI: 0.47-0.73, p < 0.001), respectively, in the two time periods, indicating persistent higher survival with bypass surgery. CONCLUSIONS: The previously observed lower death rate of coronary artery bypass surgery compared with percutaneous intervention in patients with three-vessel disease is persistent in more recent years and indicates that bypass surgery still should be the standard treatment for these patients.