Outcome after coronary artery bypass graft surgery, coronary angioplasty and stenting.
OBJECTIVE
We undertook this prospective observational study to investigate the long-term prognosis after balloon angioplasty (PTCA), coronary stenting (CS) and coronary artery bypass grafting (CABG).


RESULTS
A total number of 1038 patients with PTCA (n=499), CS (n=294) or CABG (n=245) were followed-up over a mean time of 6.4+/-1.8 years. Forty-two patients (4.0%) were lost to follow-up, leaving a study population of 996 subjects who were available for analyses. The primary and secondary endpoints were mortality and major adverse cardiac events (MACE), respectively. Overall death rate was 19.3%. Age, pulse pressure, smoking, diabetes, serum LDL cholesterol levels and left ventricular ejection fraction rather than the intervention type independently predicted mortality. The incidence rate of MACE was 53.7%. Compared to PTCA patients, CS patients had lower (hazard ratio 0.693; 95% confidence interval 0.514-0.793) and CABG patients the lowest risk of MACE (hazard ratio 0.343; 95% confidence interval 0.261-0.450). Further risk factors for MACE were serum LDL cholesterol levels, three-vessel coronary artery disease and left ventricular ejection fraction of <30%.


CONCLUSIONS
Long-term mortality does not differ among patients who received percutaneous interventions or CABG. Major adverse cardiac events occur more often in patients with previous percutaneous interventions, whereby CS has advantage over PTCA.
Völzke
Henry
H
Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Walther Rathenau Str. 48, D-17487 Greifswald, Germany. voelzke@uni-greifswald.de
Henzler
Julia
J
Menzel
Dirk
D
Robinson
Daniel M
DM
Hoffmann
Wolfgang
W
Vogelgesang
Dirk
D
John
Ulrich
U
Motz
Wolfgang
W
Rettig
Rainer
R
D017677:Age Distribution; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D015607:Stents / Q000706:statistics & numerical data*; D016019:Survival Analysis; D016896:Treatment Outcome