Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure

Sang Eun Lee, Hae Young Lee, Hyun Jai Cho, Won Seok Choe, Hokon Kim, Jin Oh Choi, Eun Seok Jeon, Min Seok Kim, Kyung Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok Min Kang, Dong Ju Choi, Byung Su Yoo, Kye Hun Kim, Myeong Chan Cho, Jae Joong Kim, Byung Hee Oh

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 languageEnglish
JournalHeart
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Percutaneous Coronary Intervention
Coronary Artery Bypass
Heart Failure
Transplants
Propensity Score
Mortality
Myocardial Ischemia
Registries
Hospitalization
Chronic Disease
Arteries
Stroke
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, S. E., Lee, H. Y., Cho, H. J., Choe, W. S., Kim, H., Choi, J. O., ... Oh, B. H. (Accepted/In press). Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure. Heart. https://doi.org/10.1136/heartjnl-2018-313242
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. / Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure. In: Heart. 2018.
@article{a866c6fe0acf4b1599e92409725bd983,
title = "Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure",
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.",
author = "Lee, {Sang Eun} and Lee, {Hae Young} and Cho, {Hyun Jai} and Choe, {Won Seok} and Hokon Kim and Choi, {Jin Oh} and Jeon, {Eun Seok} and Kim, {Min Seok} and Hwang, {Kyung Kuk} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Choi, {Dong Ju} and Yoo, {Byung Su} and Kim, {Kye Hun} and Cho, {Myeong Chan} and Kim, {Jae Joong} and Oh, {Byung Hee}",
year = "2018",
month = "1",
day = "1",
doi = "10.1136/heartjnl-2018-313242",
language = "English",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",

}

Lee, SE, Lee, HY, Cho, HJ, Choe, WS, Kim, H, Choi, JO, Jeon, ES, Kim, MS, Hwang, KK, Chae, SC, Baek, SH, Kang, SM, Choi, DJ, Yoo, BS, Kim, KH, Cho, MC, Kim, JJ & Oh, BH 2018, 'Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure', Heart. https://doi.org/10.1136/heartjnl-2018-313242

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 journalArticle

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.

UR - http://www.scopus.com/inward/record.url?scp=85053218453&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053218453&partnerID=8YFLogxK

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 -