Comparative Study of One-stop Hybrid Technology, Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention in Treating Patients With Multivessel Coronary Artery Disease
10.3969/j.issn.1000-3614.2018.01.004
- VernacularTitle:一站式复合技术与冠状动脉旁路移植术及经皮冠状动脉介入治疗在冠状动脉多支病变治疗中的对比研究
- Author:
Liu-Zhong SHEN
1
;
Sheng-Shou HU
;
Bo XU
;
Yong-Jian WU
;
Feng LV
;
Hui XIONG
;
Li-Huan LI
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心血管外科
- Keywords:
Coronary artery bypass grafting;
Angioplasty,transluminal,percutaneous coronary;
One-stop hybrid technology;
EuroSCORE;
SYNTAX score
- From:
Chinese Circulation Journal
2018;33(1):24-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the middle and long term clinical outcomes of one-stop hybrid coronary revascularization, coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in treating the patients with multivessel coronary artery disease; to explore the optimal indication of one-stop hybrid technology. Methods: Our research included in 3 groups: Hybrid group, n=141 patients received one-stop hybrid coronary revascularization in our hospital from 2006-06 to 2010-16. Meanwhile, 5797 patients received CABG and 4254 received PCI, the major pre-operative risk factors were studied by Logistic regression analysis to calculate propensity score, adjacent matching was used to respectively select 141 subjects from CABG and PCI patients to make 1:1 match with Hybrid group as CABG group and PCI group. EuroSCORE and SYNTAX score were used to make risk stratification in all 3 groups. By EuroSCORE system: low risk ≤ 2, medium risk (3-5) and high risk ≥ 6; by SYNTAX score system: low risk ≤ 24, medium risk (25-29) and high risk ≥ 30. The incidence of major adverse cardiac/cerebral vascular events (MACCE) was compared among 3 groups at different risk stratifications. Results: The mean follow-up time was 4.5 years up to 2015-01. The overall incidence of MACCE was lower in Hybrid group (9.9％) than PCI group (27.7％), P<0.001; while it was similar between Hybrid group and CABG group (19.1％), P=0.150. By EuroSCORE stratification, the incidence of MACCE in low risk and medium risk patients were similar among 3 groups; while in high risk patients, the incidence was lower in Hybrid group than both CABG group (P=0.017) and PCI group (P<0.001). By SYNTAX score stratification, the incidence of MACCE in low risk and medium risk patients were similar among 3 groups; while in high risk patients, the incidence was lower in Hybrid group than PCI group (P<0.001), it was similar between Hybrid group and CABG group (P=0.355). Conclusion: One-stop hybrid technology had the better middle and long term outcomes for treating multivessel coronary artery disease patients with high risk stratification, which provided an alternative strategy in clinical practice.
