Percutaneous coronary intervention versus coronary artery bypass grafting surgery in patients with coronary artery disease and reduced ejection fraction
10.3969/j.issn.1004-8812.2023.11.004
- VernacularTitle:冠心病合并射血分数降低患者血运重建策略:经皮冠状动脉介入治疗和冠状动脉旁路移植术的对比研究
- Author:
Shao-Ping WANG
1
;
Yan-Ci LIU
;
Zheng WU
;
Ze ZHENG
;
Hong-Yu PENG
;
Dong-Hui ZHAO
;
Fang LI
;
Shu-Juan CHENG
;
Jing-Hua LIU
Author Information
1. 100029 北京,首都医科大学附属北京安贞医院冠心病中心
- Keywords:
Coronary artery bypass grafting;
Left ventricular ejection fraction;
Heart failure;
Blood circulation reconstruction;
Support
- From:
Chinese Journal of Interventional Cardiology
2023;31(11):828-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective Current data are insufficient for comparisons of effectiveness between percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)among patients with coronary artery disease(CAD)and left ventricular dysfunction.Methods A total of 905 CAD patients with reduced left ventricular ejection fraction(LVEF≤35％)in single center of China who underwent either PCI or CABG were enrolled in a real-world cohort study.Clinical outcomes included short-and long-term all-cause mortality,rates of heart failure(HF)hospitalization and repeat revascularization.Propensity score matching was used to balance the 2 cohorts.Results PCI was associated with lower 30-day mortality rate(HR 0.29,95％CI 0.09-0.88,P=0.029).At a mean follow-up of 4.5 years,PCI and CABG had similar all-cause death(HR 1.00,95％CI 0.67-1.50,P=0.990)and HF hospitalization(HR 0.81,95％CI 0.40-1.64,P=0.561),but PCI had higher risk of repeat revascularization(HR 14.46,95％CI 3.43-60.98,P＜0.001).PCI was associated with more significant LVEF improvement than CABG(P=0.031 for interaction).Conclusions CAD patients with reduced LVEF who underwent PCI had lower short-term mortality rate and more LVEF improvement but higher risk of repeat revascularization during follow-up than patients who underwent CABG.PCI showed comparable long-term survival and HF hospitalization risk.
