Determinants and Long-Term Outcomes of Percutaneous Coronary Interventions vs. Surgery for Multivessel Disease According to Clinical Presentation

DOI Web Site Web Site PubMed 被引用文献1件 参考文献16件
  • Hong Sung-Jin
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Kim Byeong-Keuk
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Shin Sanghoon
    Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital
  • Suh Yongsung
    Division of Cardiology, Department of Internal Medicine, Myongji Hospital
  • Kim Seunghwan
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Ahn Chul-Min
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Kim Jung-Sun
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Ko Young-Guk
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Choi Donghoon
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Hong Myeong-Ki
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine
  • Jang Yangsoo
    Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine

この論文をさがす

抄録

<p>Background:The long-term outcome of percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG), particularly for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), remains controversial.</p><p>Methods and Results:We retrospectively analyzed 2,827 patients (stable coronary artery disease [SCAD], n=1,601; NSTE-ACS, n=1,226) who underwent either PCI (n=1,732) or CABG (n=1,095). The 8-year composite of cardiac death and myocardial infarction (MI) was compared between PCI and CABG before and after propensity matching. For patients with NSTE-ACS, PCI was performed more frequently for those with higher Thrombolysis in Myocardial Infarction risk score and 3-vessel disease, and PCI led to significantly higher 8-year composite of cardiac death and MI than CABG (14.1% vs. 5.9%, hazard ratio [HR]=2.22, 95% confidence interval [CI]=1.37–3.58, P=0.001). There was a significant interaction between clinical presentation and revascularization strategy (P-interaction=0.001). However, after matching, the benefit of CABG vs. PCI was attenuated in patients with NSTE-ACS, whereas it was pronounced in those with SCAD. Interactions between clinical presentation and revascularization strategy were not observed (P-interaction=0.574).</p><p>Conclusions:Although the determinants of PCI vs. CABG in real-world clinical practice differ according to the clinical presentation, a significant interaction between clinical presentation and revascularization strategy was not noted for long-term outcomes. The revascularization strategy for patients with NSTE-ACS can be based on the criteria applied to patients with SCAD.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 82 (4), 1092-1100, 2018

    一般社団法人 日本循環器学会

被引用文献 (1)*注記

もっと見る

参考文献 (16)*注記

もっと見る

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ