title: Propensity analysis of 12 years outcome after bypass graft or balloon angioplasty in patients with multivessel coronary artery disease.
abstract: BACKGROUND
  Randomized trials have shown that long-term mortality rates are similar between patients with multivessel coronary artery disease (CAD) treated by percutaneous coronary intervention (PCI) and by coronary artery bypass graft (CABG). However, there are scant data regarding more than 10 years long-term follow-up in Asian populations. Therefore, we performed a pooled analysis of our observational data evaluating long-term outcomes of PCI as compared with CABG in patients with multivessel disease among a Japanese population.
  
  
  RESULTS
  We enrolled 1364 patients, of whom 225 (16.5%) and 1139 (83.5%) underwent PCI and CABG, respectively. During follow-up (12.8±3.4 years), 377 patients died (cardiac death, 125; cardiovascular death, 177) and 322 underwent revascularization. We predicted the probability of undergoing PCI using propensity analysis. After adjusting for baseline variables including propensity score, PCI and CABG did not differ in terms of all-cause (hazard ratio (HR) 1.12; 95% confidence interval (CI) 0.72-1.73; p=0.62), cardiac (HR 0.62; 95%CI 0.32-1.23; p=0.17), and cardiovascular mortality (HR 0.83; 95%CI 0.45-1.52; p=0.54). However, the incidence of revascularization was significantly higher in the PCI group than in the CABG group (HR 0.20; 95%CI 0.15-0.28; p<0.0001).
  
  
  CONCLUSIONS
  Although PCI was associated with a significantly higher risk of revascularization than CABG, long-term mortality rates did not significantly differ between the two procedures in this oriental population.
authors.affiliation: Department of Cardiology, Juntendo University, School of Medicine, Tokyo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Kan
authors.initials: K
authors.lastname: Kajimoto
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Naozumi
authors.initials: N
authors.lastname: Kubota
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D044466:Asian People; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012086:Reoperation