Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease

Duk Woo Park, Sung Cheol Yun, Seung Whan Lee, Young Hak Kim, Cheol Whan Lee, Myeong Ki Hong, Jae Joong Kim, Suk Jung Choo, Hyun Song, Cheol Hyun Chung, Jae Won Lee, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

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Abstract

BACKGROUND - Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated. METHODS AND RESULTS - Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0% for CABG versus 4.4% for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95% confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95% CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95% CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95% CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95% CI, 2.11 to 3.75; P<0.001). CONCLUSIONS - For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG.

Original languageEnglish
Pages (from-to)2079-2086
Number of pages8
JournalCirculation
Volume117
Issue number16
DOIs
Publication statusPublished - 2008 Apr 1

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Drug-Eluting Stents
Percutaneous Coronary Intervention
Coronary Artery Bypass
Coronary Artery Disease
Mortality
Confidence Intervals
Therapeutics
Ventricular Function
Coronary Disease
Arteries

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Park, Duk Woo ; Yun, Sung Cheol ; Lee, Seung Whan ; Kim, Young Hak ; Lee, Cheol Whan ; Hong, Myeong Ki ; Kim, Jae Joong ; Choo, Suk Jung ; Song, Hyun ; Chung, Cheol Hyun ; Lee, Jae Won ; Park, Seong Wook ; Park, Seung Jung. / Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease. In: Circulation. 2008 ; Vol. 117, No. 16. pp. 2079-2086.
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title = "Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease",
abstract = "BACKGROUND - Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated. METHODS AND RESULTS - Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0{\%} for CABG versus 4.4{\%} for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95{\%} confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95{\%} CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95{\%} CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95{\%} CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95{\%} CI, 2.11 to 3.75; P<0.001). CONCLUSIONS - For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG.",
author = "Park, {Duk Woo} and Yun, {Sung Cheol} and Lee, {Seung Whan} and Kim, {Young Hak} and Lee, {Cheol Whan} and Hong, {Myeong Ki} and Kim, {Jae Joong} and Choo, {Suk Jung} and Hyun Song and Chung, {Cheol Hyun} and Lee, {Jae Won} and Park, {Seong Wook} and Park, {Seung Jung}",
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pages = "2079--2086",
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Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease. / Park, Duk Woo; Yun, Sung Cheol; Lee, Seung Whan; Kim, Young Hak; Lee, Cheol Whan; Hong, Myeong Ki; Kim, Jae Joong; Choo, Suk Jung; Song, Hyun; Chung, Cheol Hyun; Lee, Jae Won; Park, Seong Wook; Park, Seung Jung.

In: Circulation, Vol. 117, No. 16, 01.04.2008, p. 2079-2086.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term mortality after percutaneous coronary intervention with drug-eluting stent implantation versus coronary artery bypass surgery for the treatment of multivessel coronary artery disease

AU - Park, Duk Woo

AU - Yun, Sung Cheol

AU - Lee, Seung Whan

AU - Kim, Young Hak

AU - Lee, Cheol Whan

AU - Hong, Myeong Ki

AU - Kim, Jae Joong

AU - Choo, Suk Jung

AU - Song, Hyun

AU - Chung, Cheol Hyun

AU - Lee, Jae Won

AU - Park, Seong Wook

AU - Park, Seung Jung

PY - 2008/4/1

Y1 - 2008/4/1

N2 - BACKGROUND - Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated. METHODS AND RESULTS - Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0% for CABG versus 4.4% for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95% confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95% CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95% CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95% CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95% CI, 2.11 to 3.75; P<0.001). CONCLUSIONS - For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG.

AB - BACKGROUND - Although previous studies have compared the treatment effects of percutaneous coronary intervention and coronary artery bypass grafting (CABG), the long-term outcomes beyond 1 year among patients with multivessel coronary artery disease who underwent percutaneous coronary intervention with drug-eluting stents (DES) or CABG have not been evaluated. METHODS AND RESULTS - Between January 2003 and December 2005, 3042 patients with multivessel disease underwent coronary implantation of DES (n=1547) or CABG (n=1495). The primary end point was all-cause mortality. In a crude analysis, the rate of long-term mortality was significantly higher in patients who underwent CABG than in those who underwent DES implantation (3-year unadjusted mortality rate, 7.0% for CABG versus 4.4% for percutaneous coronary intervention; P=0.01). However, after adjustment for baseline differences, the overall risks of death were similar among all patients (hazard ratio, 0.85; 95% confidence interval [CI], 0.56 to 1.30; P=0.45), diabetic patients (hazard ratio, 1.76; 95% CI, 0.82 to 3.78; P=0.15), and patients with compromised ventricular function (hazard ratio, 1.39; 95% CI, 0.41 to 4.65; P=0.60). In the anatomic subgroups, mortality benefit with DES implantation was noted in patients with 2-vessel disease with involvement of the nonproximal left anterior descending artery (hazard ratio, 0.23; 95% CI, 0.01 to 0.78; P=0.016). The rate of revascularization was significantly higher in the DES than in the CABG group (hazard ratio, 2.81; 95% CI, 2.11 to 3.75; P<0.001). CONCLUSIONS - For the treatment of multivessel coronary artery disease, percutaneous coronary intervention with DES implantation showed equivalent long-term mortality as CABG.

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U2 - 10.1161/CIRCULATIONAHA.107.750109

DO - 10.1161/CIRCULATIONAHA.107.750109

M3 - Article

C2 - 18413495

AN - SCOPUS:42649108062

VL - 117

SP - 2079

EP - 2086

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 16

ER -