Long-Term Outcomes of Coronary-Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-Metal Stent Era

• DOI: 10.1161/circulationaha.107.735902
• Publication Date: 2008-09-30T01:11:46Z
• Authors: Takeshi Kimura; Takeshi Morimoto; Yutaka Furukawa; Yoshihisa Nakagawa; Satoshi Shizuta; Natsuhiko Ehara; Ryoji Taniguchi; Takahiro Doi; Kei Nishiyama; Neiko Ozasa; Naritatsu Saito; Kozo Hoshino; Hirokazu Mitsuoka; Mitsuru Abe; Masanao Toma; Toshihiro Tamura; Yoshisumi Haruna; Yukiko Imai; Satoshi Teramukai; Masanori Fukushima; Toru Kita
• Keywords: Adult; Aged, 80 and over; Male; Adolescent; Age Factors; Coronary Artery Disease; Middle Aged; Survival Analysis; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Metals; Humans; Female; Stents; Longitudinal Studies; Registries; Angioplasty, Balloon, Coronary; Coronary Artery Bypass; Child; Aged

Background— Observational registries comparing coronary artery bypass graft (CABG) surgery and percutaneous intervention (PCI) have reported long-term survival results that are discordant with those of randomized trials. Methods Results— We conducted a multicenter study in Japan enrolling consecutive patients undergoing first CABG or PCI between January 2000 December 2002. Among 9877 enrolled, 5420 (PCI: 3712, CABG: 1708) had multivessel disease without left main involvement. Because age is an important determinant when choosing revascularization strategies, analysis was stratified by either ≥75 <75 years. Analyses were also performed other relevant subgroups. Median follow-up interval 1284 days 95% rate at 2 At 3 years, unadjusted rates 91.7% 89.6% the groups, respectively (log rank P =0.26). After adjustment for baseline characteristics, outcome tended to be better after (hazard ratio death versus [HR], confidence [CI]: 1.23 [0.99-1.53], =0.06). Adjusted outcomes among elderly (HR [95%CI]: 1.37 [0.98-1.92] =0.07), but not nonelderly [95% CI]: 1.09 [0.82-1.46], =0.55). Unadjusted adjusted significantly different any subgroups excluded from analysis. Conclusions— In CREDO-Kyoto registry, years similar CABG, result consistent