CABG more effective than PCI in treatment of non-emergency multi-vessel coronary disease in older patients

Published date : 03 May 2012
Article date : 03 May 2012

A collaborative observational study undertaken by the American College of Cardiology Foundation (ACCF) and the Society of Thoracic Surgeons (STS) compares the effectiveness of percutaneous coronary intervention (PCI) and coronary-artery bypass grafting (CABG) in the treatment of older patients with two- or three-vessel coronary artery disease not requiring emergency treatment.

The study, which links data from the ACCF National Cardiovascular Data Registry and the STS Adult Cardiac Surgery Database, to claims data from the Centers for Medicare and Medicaid Services, compares long-term survival rates in 86,244 patients aged 65 or over who have undergone CABG surgery and 103,549 patients receiving PCI treatment. While there is no reported significant difference in adjusted mortality rates between the two groups at the 1 year follow-up mark, at 4 years patients treated with CABG reveal lower rates of mortality compared to those who have undergone PCI (16.4% vs. 20.8%; risk ratio, 0.79; 95% CI, 0.76 to 0.82). Similar findings were noted with several different methods of analysis and in multiple patient subgroups.
To access the full New England Journal of Medicine summary of this study, click here.
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