Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents

Chuntao Wu, Fabian T. Camacho, Songyang Zhao, Andrew S. Wechsler, Alfred T. Culliford, Stephen J. Lahey, Spencer B. King, Gary D Walford, Jeffrey P. Gold, Craig R. Smith, Desmond Jordan, Robert Higgins, Edward L. Hannan

Research output: Contribution to journalArticle

Abstract

Background: Few studies have examined differences in long-term mortality between coronary artery bypass graft surgery and stenting with drug-eluting stents (DES) for multivessel disease without left main coronary artery stenosis. This study compares the risks of long-term mortality between these 2 procedures during a follow-up of up to 5 years. Methods: Patients who underwent isolated bypass surgery (n = 13,212) and stenting with DES (n = 20,161) between October 2003 and December 2005 in New York State were followed for their vital status through 2008. To control for treatment selection bias, bypass and stenting patients were matched on age, number of diseased coronary vessels, presence of proximal or nonproximal left anterior descending (LAD) artery disease, and propensity of undergoing bypass surgery. Five-year survival rates for the 2 procedures were compared and hazard ratios for death of bypass surgery compared with stenting were obtained. Results: The respective 5-year survival rates in the 8,121 pairs of matched bypass and stenting patients were 80.4% and 73.6% (p <0.001), and the risk of death after bypass surgery was 29% lower than for stenting (hazard ratio = 0.71, 95% confidence interval: 0.67 to 0.77, p <0.001). Significantly lower risks of death for bypass surgery were observed in patients with LAD artery disease but not in patients without LAD artery disease. Significantly lower risks of death for bypass surgery were also found in all patient subgroups defined by the presence of selected baseline risk factors. Conclusions: Bypass surgery is associated with lower risk of death than stenting with DES for multivessel disease without left main stenosis.

Original languageEnglish (US)
Pages (from-to)1297-1305
Number of pages9
JournalAnnals of Thoracic Surgery
Volume95
Issue number4
DOIs
StatePublished - Apr 2013

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Drug-Eluting Stents
Coronary Artery Bypass
Transplants
Mortality
Arteries
Survival Rate
Selection Bias
Coronary Stenosis
Coronary Vessels
Pathologic Constriction
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Wu, C., Camacho, F. T., Zhao, S., Wechsler, A. S., Culliford, A. T., Lahey, S. J., ... Hannan, E. L. (2013). Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents. Annals of Thoracic Surgery, 95(4), 1297-1305. https://doi.org/10.1016/j.athoracsur.2012.11.073

Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents. / Wu, Chuntao; Camacho, Fabian T.; Zhao, Songyang; Wechsler, Andrew S.; Culliford, Alfred T.; Lahey, Stephen J.; King, Spencer B.; Walford, Gary D; Gold, Jeffrey P.; Smith, Craig R.; Jordan, Desmond; Higgins, Robert; Hannan, Edward L.

In: Annals of Thoracic Surgery, Vol. 95, No. 4, 04.2013, p. 1297-1305.

Research output: Contribution to journalArticle

Wu, C, Camacho, FT, Zhao, S, Wechsler, AS, Culliford, AT, Lahey, SJ, King, SB, Walford, GD, Gold, JP, Smith, CR, Jordan, D, Higgins, R & Hannan, EL 2013, 'Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents', Annals of Thoracic Surgery, vol. 95, no. 4, pp. 1297-1305. https://doi.org/10.1016/j.athoracsur.2012.11.073
Wu, Chuntao ; Camacho, Fabian T. ; Zhao, Songyang ; Wechsler, Andrew S. ; Culliford, Alfred T. ; Lahey, Stephen J. ; King, Spencer B. ; Walford, Gary D ; Gold, Jeffrey P. ; Smith, Craig R. ; Jordan, Desmond ; Higgins, Robert ; Hannan, Edward L. / Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents. In: Annals of Thoracic Surgery. 2013 ; Vol. 95, No. 4. pp. 1297-1305.
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abstract = "Background: Few studies have examined differences in long-term mortality between coronary artery bypass graft surgery and stenting with drug-eluting stents (DES) for multivessel disease without left main coronary artery stenosis. This study compares the risks of long-term mortality between these 2 procedures during a follow-up of up to 5 years. Methods: Patients who underwent isolated bypass surgery (n = 13,212) and stenting with DES (n = 20,161) between October 2003 and December 2005 in New York State were followed for their vital status through 2008. To control for treatment selection bias, bypass and stenting patients were matched on age, number of diseased coronary vessels, presence of proximal or nonproximal left anterior descending (LAD) artery disease, and propensity of undergoing bypass surgery. Five-year survival rates for the 2 procedures were compared and hazard ratios for death of bypass surgery compared with stenting were obtained. Results: The respective 5-year survival rates in the 8,121 pairs of matched bypass and stenting patients were 80.4{\%} and 73.6{\%} (p <0.001), and the risk of death after bypass surgery was 29{\%} lower than for stenting (hazard ratio = 0.71, 95{\%} confidence interval: 0.67 to 0.77, p <0.001). Significantly lower risks of death for bypass surgery were observed in patients with LAD artery disease but not in patients without LAD artery disease. Significantly lower risks of death for bypass surgery were also found in all patient subgroups defined by the presence of selected baseline risk factors. Conclusions: Bypass surgery is associated with lower risk of death than stenting with DES for multivessel disease without left main stenosis.",
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T1 - Long-term mortality of coronary artery bypass graft surgery and stenting with drug-eluting stents

AU - Wu, Chuntao

AU - Camacho, Fabian T.

AU - Zhao, Songyang

AU - Wechsler, Andrew S.

AU - Culliford, Alfred T.

AU - Lahey, Stephen J.

AU - King, Spencer B.

AU - Walford, Gary D

AU - Gold, Jeffrey P.

AU - Smith, Craig R.

AU - Jordan, Desmond

AU - Higgins, Robert

AU - Hannan, Edward L.

PY - 2013/4

Y1 - 2013/4

N2 - Background: Few studies have examined differences in long-term mortality between coronary artery bypass graft surgery and stenting with drug-eluting stents (DES) for multivessel disease without left main coronary artery stenosis. This study compares the risks of long-term mortality between these 2 procedures during a follow-up of up to 5 years. Methods: Patients who underwent isolated bypass surgery (n = 13,212) and stenting with DES (n = 20,161) between October 2003 and December 2005 in New York State were followed for their vital status through 2008. To control for treatment selection bias, bypass and stenting patients were matched on age, number of diseased coronary vessels, presence of proximal or nonproximal left anterior descending (LAD) artery disease, and propensity of undergoing bypass surgery. Five-year survival rates for the 2 procedures were compared and hazard ratios for death of bypass surgery compared with stenting were obtained. Results: The respective 5-year survival rates in the 8,121 pairs of matched bypass and stenting patients were 80.4% and 73.6% (p <0.001), and the risk of death after bypass surgery was 29% lower than for stenting (hazard ratio = 0.71, 95% confidence interval: 0.67 to 0.77, p <0.001). Significantly lower risks of death for bypass surgery were observed in patients with LAD artery disease but not in patients without LAD artery disease. Significantly lower risks of death for bypass surgery were also found in all patient subgroups defined by the presence of selected baseline risk factors. Conclusions: Bypass surgery is associated with lower risk of death than stenting with DES for multivessel disease without left main stenosis.

AB - Background: Few studies have examined differences in long-term mortality between coronary artery bypass graft surgery and stenting with drug-eluting stents (DES) for multivessel disease without left main coronary artery stenosis. This study compares the risks of long-term mortality between these 2 procedures during a follow-up of up to 5 years. Methods: Patients who underwent isolated bypass surgery (n = 13,212) and stenting with DES (n = 20,161) between October 2003 and December 2005 in New York State were followed for their vital status through 2008. To control for treatment selection bias, bypass and stenting patients were matched on age, number of diseased coronary vessels, presence of proximal or nonproximal left anterior descending (LAD) artery disease, and propensity of undergoing bypass surgery. Five-year survival rates for the 2 procedures were compared and hazard ratios for death of bypass surgery compared with stenting were obtained. Results: The respective 5-year survival rates in the 8,121 pairs of matched bypass and stenting patients were 80.4% and 73.6% (p <0.001), and the risk of death after bypass surgery was 29% lower than for stenting (hazard ratio = 0.71, 95% confidence interval: 0.67 to 0.77, p <0.001). Significantly lower risks of death for bypass surgery were observed in patients with LAD artery disease but not in patients without LAD artery disease. Significantly lower risks of death for bypass surgery were also found in all patient subgroups defined by the presence of selected baseline risk factors. Conclusions: Bypass surgery is associated with lower risk of death than stenting with DES for multivessel disease without left main stenosis.

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