TY - JOUR
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
AU - Gold, Jeffrey P.
AU - Smith, Craig R.
AU - Jordan, Desmond
AU - Higgins, Robert S.D.
AU - Hannan, Edward L.
N1 - Funding Information:
We thank the New York State Cardiac Advisory Committee for their encouragement and support of this study; and Kimberly Cozzens, Cynthia Johnson, Rosemary Lombardo, and the cardiac catheterization laboratories and cardiac surgery programs of the participating hospitals for their tireless efforts to ensure the timeliness, completeness, and accuracy of the registry data. This work was supported by the National Institutes of Health ( RC1HL099122 ).
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.
UR - http://www.scopus.com/inward/record.url?scp=84875306253&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875306253&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2012.11.073
DO - 10.1016/j.athoracsur.2012.11.073
M3 - Article
C2 - 23391171
AN - SCOPUS:84875306253
SN - 0003-4975
VL - 95
SP - 1297
EP - 1305
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 4
ER -