Author + information
- Piotr Desperak1,
- Michal Hawranek2,
- Pawel Gasior3,
- Aneta Ciślak1,
- Marek Gierlotka4,
- Lukasz Pyka1,
- Andrzej Lekston2 and
- Mariusz Gasior1
- 13rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland, Zabrze, Poland
- 23rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
- 3CRF Skirball Center for Innovation, Orangeburg, New York, United States
- 43rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
There is a lack of clinical trials comparing Multivessel Percutaneous Coronary Intervention (MV PCI) with Coronary Artery Bypass Grafting (CABG) in patients presenting non-ST-segment elevation acute coronary syndromes (NSTE-ACS). We sought to compare long-term outcomes of MV PCI with CABG in patients with advanced coronary artery disease and NSTE-ACS.
A total of 3,166 consecutive patients with NSTE-ACS from ongoing, prospective registry, hospitalized in 2006-2014 were analyzed. For further analysis patients with left main, proximal left anterior descending artery or triple-vessel coronary artery disease were included. 455 patients were enrolled and divided into two groups (MVPCI or CABG group). Cox proportional hazards model and propensity scores matching were used to adjust for differences in patients’ baseline characteristics. The primary outcome measure encompassed combined endpoint (all-cause death, non-fatal myocardial infarction (MI), ACS-driven revascularization and stroke) and all-cause death at 36 months.
MV PCI was performed in 335 pts., whereas remaining 120 pts. underwent CABG. After propensity score analysis, 99 well-matched pairs. were chosen. At 36 month, MV PCI was associated with similar combined endpoint after both Cox proportional hazards model (hazard ratio [HR] 1.26; 95% confidence interval [CI] 0.75,2.11; P=0.39) and propensity matched analysis (HR 1.28; 95% CI 0.75, 2.21; P=0.36). Furthermore, rates of 36-month all-cause mortality were also comparable in both group before (HR 0.90; 95% CI 0.46,1.75; P=0.76) and after matching (HR 0.94; 95% CI 0.47, 1.89; P=0.87).
Long-term results of MV PCI are comparable to CABG in treatment of severe CAD in NSTE-ACS.
CORONARY: Acute Coronary Syndromes