Five-year outcomes after coronary artery bypass grafting and percutaneous coronary intervention in octogenarians with complex coronary artery disease View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-10-06

AUTHORS

Hiroyuki Hara, Hiroki Watanabe, Jiro Esaki, Yuki Hori, Shingo Hirao, Naoki Kanemitsu, Takeshi Morimoto, Tatsuhiko Komiya, Kenji Minatoya, Takeshi Kimura

ABSTRACT

ObjectiveWe assessed the clinical effectiveness of coronary artery bypass grafting (CABG) in comparison with that of percutaneous coronary intervention (PCI) in octogenarians with triple-vessel disease (TVD) or left main coronary artery (LMCA) disease.MethodsFrom the CREDO-Kyoto registry cohort-2, 527 patients, who were ≥ 80 years of age and underwent the first coronary revascularization for TVD or LMCA disease, were divided into the CABG group (N = 151) and the PCI group (N = 376).ResultsThe median and interquartile range of patient’s age was 82 (81–84) in the CABG group and 83 (81–85) in the PCI group (P = 0.10). Patients > = 85 years of age accounted for 19% and 31% in the CABG and PCI groups, respectively (P = 0.01).The cumulative 5-year incidence of all-cause death was similar between CABG and PCI groups (35.8% vs. 42.9%, log-rank P = 0.18), while CABG showed a lower rate of the composite of cardiac death/MI than PCI (21.7% vs. 33.9%, log-rank P = 0.005). After adjusting for confounders, the lower risk of CABG relative to PCI was significant for all-cause death (HR 0.61, 95% CI 0.43–0.86, P = 0.005), any coronary revascularization (HR 0.25, 95% CI 0.14–0.43, P < 0.001) and the composite of cardiac death/MI (HR 0.52, 95% CI 0.32–0.85, P = 0.009).ConclusionsCABG compared with PCI was associated with a lower adjusted risk for all-cause death, any coronary revascularization, and a composite of cardiac death/MI in very elderly patients with TVD or LMCA disease. CABG seemed an acceptable option for selected octogenarians with severe coronary artery disease. More... »

PAGES

419-429

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11748-021-01711-4

DOI

http://dx.doi.org/10.1007/s11748-021-01711-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1141649356

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34613579


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