Comparative Study Between Revascularization and Medical Therapy in Patients With Severe Coronary Artery Lesions Diagnosed by Elective Coronary Angiography
10.3969/j.issn.1000-3614.2015.08.004
- VernacularTitle:择期冠状动脉造影发现冠状动脉严重病变的再血管化治疗和保守治疗的对比分析
- Author:
Huawei GAO
;
Zhe ZHENG
;
Yanyan ZHAO
;
Yang WANG
;
Bo XU
;
Liang XU
;
Wei LI
;
Shengshou HU
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Follow-up study;
Revascularization
- From:
Chinese Circulation Journal
2015;(8):733-736
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the long term prognosis between revascularization (REV) and medical therapy (MP) in patients with three-vessel disease (3VD) with or without left main (LM) lesion.
Methods: A total of 4,875 consecutive patients with elective coronary angiography (CAG) diagnosed 3VD with or without LM lesion treated in our hospital from 2007-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups: MT group,n=705 (14.5%) and REV group,n=4170 (85.5%). The all cause mortality and the rate of revascularization during follow-up period were compared between 2 groups by inverse-probability-weighting approach with propensity score.
Results: There were 3962/4875 (81.3%) patients with simple 3VD (right, left anterior descending and left circumlfex coronary arteries) and 913 (18.7%) with 3VD+LM lesion. The in-hospital mortality was similar between 2 groups (OR=0.7, 95% CI 0.3-1.4,P=0.30). With the longest 2-year follow-up study, the adjusted all cause mortality and the rate of revascularization in MT group were both higher than those in REV group (HR=8.3, 95% CI 6.7-11.1,P<0.001) and (HR=1.4, 95% CI 1.1-1.6,P<0.001). No matter the patients with simple 3VD or 3VD+LM lesion, compared with REV group, MT group had the higher all cause mortality, for 3VD+LM lesion (HR=10.4, 95% CI 7.1-15.4,P<0.001) and for simple 3VD (HR=7.1, 95% CI 5.3-10.0,P<0.001).
Conclusion: In real world, the long term prognosis by revascularization treatment was superior to medical treatment in patients with either simple 3 vessel coronary disease or 3 vessel combining LM disease.
