Comparison of intermediate-term outcomes of coronary artery bypass grafting versus drug-eluting stents for patients ≥75 years of age.
Several randomized controlled trials and observational studies have compared outcomes of percutaneous coronary interventions (PCIs) with drug-eluting stents (DESs) and coronary artery bypass grafting (CABG), but they have not thoroughly investigated the relative difference in outcomes for patients aged ≥75 years. In this study, a total of 3,864 patients receiving DES and CABG (1,932 CABG-DES pairs) with multivessel coronary disease were propensity matched using multiple patient risk factors and were compared with respect to 3 outcomes (mortality, stroke/myocardial infarction [MI]/mortality, and repeat revascularization) at 2.5 years with a mean follow-up of 18 months. The mortality rates (DES/CABG hazard ratio 1.06, 95% confidence interval 0.87 to 1.30) and the stroke/MI/mortality rates (DES/CABG hazard ratio 1.15, 95% confidence interval 0.97 to 1.38) for the 2 procedures were not significantly different. Repeat revascularization rates were significantly higher for patients who received DESs. In conclusion, older patients experienced similar mortality and stroke/MI/mortality rates for CABG and PCI with DES, although repeat revascularization rates were higher for patients undergoing PCI with DES.
University at Albany, State University of New York, Albany, New York. Electronic address: elh03@health.state.ny.us.
Edward L
EL
Hannan
University at Albany, State University of New York, Albany, New York.
Ye
Y
Zhong
Geisinger Medical Center, Danville, Pennsylvania.
Peter B
PB
Berger
Johns Hopkins University, Baltimore, Maryland.
Gary
G
Walford
Yale School of Medicine, New Haven, Connecticut.
Jeptha P
JP
Curtis
Penn State Hershey College of Medicine, Hershey, Pennsylvania.
Chuntao
C
Wu
Albany Medical Center, Albany, New York.
Ferdinand J
FJ
Venditti
The Ohio State University, Columbus, Ohio.
Robert S D
RS
Higgins
Columbia-Presbyterian Medical Center, New York, New York.
Craig R
CR
Smith
University of Connecticut Health Center, Storrs, Connecticut.
Stephen J
SJ
Lahey
St. Joseph's Health System, Atlanta, Georgia.
Spencer B
SB
King
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D057186:Comparative Effectiveness Research; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D023921:Coronary Stenosis / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003925:Diabetic Angiopathies / Q000601:surgery / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D062645:Percutaneous Coronary Intervention; D057216:Propensity Score; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012042:Registries; D019233:Retreatment; D012307:Risk Factors; D016896:Treatment Outcome
D003404:Creatinine