Comparison of therapeutic effect between PCI and CABG on multi-vessel coronary disease
10.3969／j.issn.1008－0074.2019.03.14
- VernacularTitle:冠心病多支病变支架植入术与冠脉旁路移植术疗效的比较
- Author:
Zhao-Xia WANG
1
;
Ying-Min LU
;
Hong-Qiang LIU
;
Jin-Chun ZHANG
;
Da-Min HUANG
;
Xiao-Han LUO
;
Dong-Mei YUE
;
Jian JI
;
Lei SONG
;
Zhi-Hua LI
;
Wei-Ping XU
Author Information
1. 上海交通大学医学院附属新华医院崇明分院心内科
- Keywords:
Coronary artery disease;
Coronary artery bypass,off-pump;
Stents
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2019;28(3):318-322
- CountryChina
- Language:Chinese
-
Abstract:
Objective :To compare short-term and midterm therapeutic effect between sirolimus-eluting stent implan-tation (SES-PCI) and coronary artery bypass graft (CABG) in aged patients with coronary heart disease (CHD) and multi-vessel coronary disease (MVD).Methods : Aged MVD patients undergoing selective revascularization were en-rolled and divided into CABG group (n＝301) and SES-PCI group (n＝289).Major adverse cardio-and cerebrovas-cular events (MACCE) were followed up for 30d ,one ,two and five years .Logistic multi-factor regression was used to analyze independent risk factors for different therapeutic methods .Results : Compared with CABG group after 30d follow-up ,there was significant reduction in all-cause mortality (6-3% vs.2-8%) and significant rise in a sec-ond revascularization rate (RVR ,1-3% vs.8-3%) in SES-PCI group , P＜0-05 or ＜0-01 ;compared with CABG group during one ,two and five-year follow up ,there were significant reductions in all-cause mortality [one year :(11-6% vs.4-8%) ,five years :(23-3% vs.12-1%)] and incidence rate of cerebrovascular accidents [one year :(8-6% vs .3-5%) ,five years :(18-3% vs.6-9%)] ,and significant rise in incidence rate of non-fatal myocardial infarction [one year :(6-6% vs.11-8%) ,five years :(12-0% vs.24-9%)] and a second RVR [one year :(3-0%vs.16-3%) ,five years :(9-3% vs.24-6%)] in SES-PCI group , P＜0-05 or ＜0-01- Logistic multi-factor regres-sion analysis indicated that DM and EH were independent risk factors for SES-PCI (OR＝ 45-772 ,13-218 , P＝0-001 both) ,while peripheral vascular disease was independent protective factor for SES-PCI (OR＝ 0-007 , P＝0-001).Conclusion : Compared with CABG ,there are significant reductions in short-term and midterm all-cause mortality ,and significant rise in a second RVR in MVD patients undergoing PCI .
