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Coronary Artery Bypass Grafting Versus Drug-Eluting Stents Implantation for Previous Myocardial Infarction.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2016 Jul 01; Vol. 118 (1), pp. 17-22. Date of Electronic Publication: 2016 Apr 21. - Publication Year :
- 2016
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Abstract
- Patients with previous myocardial infarction (MI) have a high risk of recurrence. Little is known about the effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with a previous MI and left main or multivessel coronary artery disease (CAD). We compared long-term outcomes of these 2 strategies in 672 patients with previous MI and left main or multivessel CAD, who underwent CABG (n = 349) or PCI with DES (n = 323). A pooled database from the BEST, PRECOMBAT, and SYNTAX trials was analyzed, and the primary outcome was a composite of death from any causes, MI, or stroke. Baseline characteristics were similar between the 2 groups. The median follow-up duration was 59.8 months. The rate of the primary outcome was significantly lower with CABG than PCI (hazard ratio [HR] 0.59, 95% CI 0.42 to 0.82; p = 0.002). This difference was driven by a marked reduction in the rate of MI (HR 0.29, 95% CI 0.16 to 0.55, p <0.001). The benefit of CABG over PCI was consistent across all major subgroups. The individual risks of death from any causes or stroke were comparable between the 2 groups. Conversely, the rate of repeat revascularization was significantly lower with CABG than PCI (HR 0.34, 95% CI 0.22 to 0.51, p <0.001). In conclusion, in the patients with previous MI and left main or multivessel CAD, compared to PCI with DES, CABG significantly reduces the risk of death from any causes, MI, or stroke.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Coronary Artery Disease complications
Coronary Artery Disease mortality
Female
Humans
Male
Middle Aged
Myocardial Infarction etiology
Myocardial Infarction mortality
Retrospective Studies
Treatment Outcome
Coronary Artery Bypass
Coronary Artery Disease therapy
Drug-Eluting Stents
Myocardial Infarction therapy
Percutaneous Coronary Intervention
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 118
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 27181565
- Full Text :
- https://doi.org/10.1016/j.amjcard.2016.04.009