Abstract
Objective: Myocardial ischaemia is a leading cause of acute heart failure (AHF). However, optimal revascularisation strategies in AHF are unclear. We aimed to compare two revascularisation strategies, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), in patients with AHF. Methods: Among 5625 consecutive patients enrolled prospectively in the Korean Acute Heart Failure registry from March 2011 to February 2014, 717 patients who received CABG or PCI during the index hospitalisation for AHF were included in this analysis. We compared adverse outcomes (death, rehospitalisation for HF aggravation or cardiovascular causes, ischaemic stroke and a composite outcome of death and rehospitalisation for HF aggravation or cardiovascular causes) with the use of propensity score matching. Results: For the propensity score-matched cohort with 190 patients, CABG had a lower risk of all-cause mortality than PCI (83 vs 147 deaths per 1000 patient-years; HR 0.57, 95% CI 0.34 to 0.96, p=0.033) during the median follow-up of 4 years. There was also a trend towards lower rates of rehospitalisation due to cardiovascular events or HF aggravation. Subgroup analysis revealed that the adverse outcomes were significantly lower in the CABG group than in PCI group, especially in patients with old age, three-vessel diseases, significant proximal left anterior descending artery disease and those without left main vessel disease or chronic total occlusion. Conclusions: Compared with PCI, CABG is associated with significant lower all-cause mortality in patients with AHF. Further studies should evaluate proper revascularisation strategies in AHF. Clinical trial registration: NCT01389843; Results.
| Original language | English |
|---|---|
| Journal | Heart |
| DOIs | |
| Publication status | Accepted/In press - 2018 Jan 1 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure. / Lee, Sang Eun; Lee, Hae Young; Cho, Hyun Jai; Choe, Won Seok; Kim, Hokon; Choi, Jin Oh; Jeon, Eun Seok; Kim, Min Seok; Hwang, Kyung Kuk; Chae, Shung Chull; Baek, Sang Hong; Kang, Seok Min; Choi, Dong Ju; Yoo, Byung Su; Kim, Kye Hun; Cho, Myeong Chan; Kim, Jae Joong; Oh, Byung Hee.
In: Heart, 01.01.2018.Research output: Contribution to journal › Article
TY - JOUR
T1 - Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure
AU - Lee, Sang Eun
AU - Lee, Hae Young
AU - Cho, Hyun Jai
AU - Choe, Won Seok
AU - Kim, Hokon
AU - Choi, Jin Oh
AU - Jeon, Eun Seok
AU - Kim, Min Seok
AU - Hwang, Kyung Kuk
AU - Chae, Shung Chull
AU - Baek, Sang Hong
AU - Kang, Seok Min
AU - Choi, Dong Ju
AU - Yoo, Byung Su
AU - Kim, Kye Hun
AU - Cho, Myeong Chan
AU - Kim, Jae Joong
AU - Oh, Byung Hee
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: Myocardial ischaemia is a leading cause of acute heart failure (AHF). However, optimal revascularisation strategies in AHF are unclear. We aimed to compare two revascularisation strategies, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), in patients with AHF. Methods: Among 5625 consecutive patients enrolled prospectively in the Korean Acute Heart Failure registry from March 2011 to February 2014, 717 patients who received CABG or PCI during the index hospitalisation for AHF were included in this analysis. We compared adverse outcomes (death, rehospitalisation for HF aggravation or cardiovascular causes, ischaemic stroke and a composite outcome of death and rehospitalisation for HF aggravation or cardiovascular causes) with the use of propensity score matching. Results: For the propensity score-matched cohort with 190 patients, CABG had a lower risk of all-cause mortality than PCI (83 vs 147 deaths per 1000 patient-years; HR 0.57, 95% CI 0.34 to 0.96, p=0.033) during the median follow-up of 4 years. There was also a trend towards lower rates of rehospitalisation due to cardiovascular events or HF aggravation. Subgroup analysis revealed that the adverse outcomes were significantly lower in the CABG group than in PCI group, especially in patients with old age, three-vessel diseases, significant proximal left anterior descending artery disease and those without left main vessel disease or chronic total occlusion. Conclusions: Compared with PCI, CABG is associated with significant lower all-cause mortality in patients with AHF. Further studies should evaluate proper revascularisation strategies in AHF. Clinical trial registration: NCT01389843; Results.
AB - Objective: Myocardial ischaemia is a leading cause of acute heart failure (AHF). However, optimal revascularisation strategies in AHF are unclear. We aimed to compare two revascularisation strategies, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), in patients with AHF. Methods: Among 5625 consecutive patients enrolled prospectively in the Korean Acute Heart Failure registry from March 2011 to February 2014, 717 patients who received CABG or PCI during the index hospitalisation for AHF were included in this analysis. We compared adverse outcomes (death, rehospitalisation for HF aggravation or cardiovascular causes, ischaemic stroke and a composite outcome of death and rehospitalisation for HF aggravation or cardiovascular causes) with the use of propensity score matching. Results: For the propensity score-matched cohort with 190 patients, CABG had a lower risk of all-cause mortality than PCI (83 vs 147 deaths per 1000 patient-years; HR 0.57, 95% CI 0.34 to 0.96, p=0.033) during the median follow-up of 4 years. There was also a trend towards lower rates of rehospitalisation due to cardiovascular events or HF aggravation. Subgroup analysis revealed that the adverse outcomes were significantly lower in the CABG group than in PCI group, especially in patients with old age, three-vessel diseases, significant proximal left anterior descending artery disease and those without left main vessel disease or chronic total occlusion. Conclusions: Compared with PCI, CABG is associated with significant lower all-cause mortality in patients with AHF. Further studies should evaluate proper revascularisation strategies in AHF. Clinical trial registration: NCT01389843; Results.
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U2 - 10.1136/heartjnl-2018-313242
DO - 10.1136/heartjnl-2018-313242
M3 - Article
AN - SCOPUS:85053218453
JO - Heart
JF - Heart
SN - 1355-6037
ER -