Author + information
- Tonga Nfor,
- Kambiz Shetabi,
- Wael Hassan,
- Quinta Nfor,
- Jayant Khitha,
- Anjan Gupta,
- Tanvir Bajwa and
- Suhail Allaqaband
Previous studies comparing percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG) in patients with left main or three–vessel coronary artery disease (LM–3VD) have excluded patients at high surgical risk.
Our nonrandomized prospective study included patients with symptomatic LM–3VD who had Society of Thoracic Surgeons (STS)–predicted operative mortality scores of >5% and were revascularized by PCI or CABG at a tertiary care center from Jan. 2009 to Dec. 2010. Propensity score, baseline surgical risk and coronary angiographic findings were adjusted for so as to preclude treatment selection bias.
Mean STS–predicted operative mortality was 14.5 ± 5.8% for PCI (n=83) vs. 13.6 ± 7.1% for CABG (n=187), p=0.31. Mean SYNTAX score was 37 ± 12 for PCI vs. 40 ± 15 for CABG, p=0.11. After mean follow–up of 3.1 years, incidence of the composite primary endpoint (death, acute myocardial infarction or stroke) was 42.2% for PCI and 39.6% for CABG, p 0.69. There was no difference in secondary endpoints except for repeat revascularization (Table). Major adverse cardiac and cerebrovascular event (MACCE) rates were not significantly different between PCI and CABG. There was no difference in the primary endpoint whether the SYNTAX score was ≤22 or >22.
The composite rate of death, acute myocardial infarction or stroke as well as rate of MACCE are similar for PCI and CABG in patients with symptomatic LM–3VD who have STS–predicted perioperative mortality >5%.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Multivessel Disease
Abstract Category: 45. TCT@ACC–i2: Coronary Intervention, Multivessel disease
Presentation Number: 2104–263
- 2013 American College of Cardiology Foundation