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

86 Citations (Scopus)

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

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

  • Cite this

    Park, D. W., Yun, S. C., Lee, S. W., Kim, Y. H., Lee, C. W., Hong, M. K., Kim, J. J., Choo, S. J., Song, H., Chung, C. H., Lee, J. W., Park, S. W., & Park, S. J. (2008). 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. Circulation, 117(16), 2079-2086. https://doi.org/10.1161/CIRCULATIONAHA.107.750109