Long-Term Comparison of Drug-Eluting Stents and Coronary Artery Bypass Grafting for Multivessel Coronary Revascularization 5-Year Outcomes From the Asan Medical Center-Multivessel Revascularization Registry

被引：48

作者：

Park, Duk-Woo ^{[1
]}

Kim, Young-Hak ^{[1
]}

Song, Hae-Geun ^{[1
]}

Ahn, Jung-Min ^{[1
]}

Oh, Junhyok ^{[1
]}

Kim, Won-Jang ^{[1
]}

Lee, Jong-Young ^{[1
]}

Kang, Soo-Jin ^{[1
]}

Lee, Seung-Whan ^{[1
]}

Lee, Cheol-Whan ^{[1
]}

Park, Seong-Wook ^{[1
]}

Yun, Sung-Cheol ^{[3
]}

Jung, Sung Ho ^{[2
]}

Choo, Suk-Jung ^{[2
]}

Chung, Cheol-Hyun ^{[2
]}

Lee, Jae-Won ^{[2
]}

Park, Seung-Jung ^{[1
]}

机构：

[1] Univ Ulsan, Coll Med, Div Cardiol, Asan Med Ctr, Seoul 138736, South Korea

[2] Univ Ulsan, Coll Med, Div Cardiac Surg, Asan Med Ctr, Seoul 138736, South Korea

[3] Univ Ulsan, Coll Med, Ctr Med Res & Informat, Div Biostat, Seoul 138736, South Korea

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2011年 / 57卷 / 02期

关键词：

coronary disease; revascularization; stents; surgery; ROUTINE CLINICAL-PRACTICE; 3-YEAR FOLLOW-UP; CARDIAC-SURGERY; INTERVENTION; DISEASE; THROMBOSIS; IMPLANTATION; MODELS; SYSTEM; PCI;

D O I：

10.1016/j.jacc.2010.09.022

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives We performed the long-term (5-year) follow-up of a large cohort of patients who underwent drug-eluting stent (DES) or coronary artery bypass graft (CABG) surgery for multivessel revascularization. Background Limited information is available on very long-term outcomes after multivessel DES treatment relative to CABG. Methods We evaluated 3,042 patients with multivessel disease who received DES (n = 1,547) or underwent CABG (n = 1,495) between January 2003 and December 2005, and for whom complete follow-up data were available for a median 5.6 years (interquartile range: 4.6 to 6.3 years). We compared adverse outcomes (death; a composite outcome of death, myocardial infarction, or stroke; and repeat revascularization). Results After adjustment for differences in baseline risk factors, 5-year risk of death (hazard ratio [HR]: 1.00; 95% confidence interval [CI]: 0.76 to 1.32, p = 0.99) and the combined risk of death, myocardial infarction, or stroke (HR: 0.97; 95% CI: 0.76 to 1.24, p = 0.81) were similar between the DES group and the CABG group. However, the rates of revascularization were significantly higher in the DES group (HR: 2.93; 95% CI: 2.20 to 3.90, p < 0.001). Similar results were obtained in comparisons of DES with CABG for high-risk clinical and anatomic subgroups with diabetes mellitus, abnormal ventricular function, age 65 years or more, and 3-vessel and left main disease. However, mortality benefit with DES implantation relative to CABG was noted in patients with 2-vessel disease (HR: 0.57; 95% CI: 0.36 to 0.92, p = 0.02). Conclusions For patients with multivessel disease, DES treatment, compared with CABG, showed similar rates of mortality and of the composite safety outcomes, but higher rates of revascularization up to 5 years. (J Am Coll Cardiol 2011;57:128-37) (C) 2011 by the American College of Cardiology Foundation

引用

页码：128 / 137

页数：10

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