Artikel
Outcome after Coronary Artery Bypass Graft Surgery, Coronary Angioplasty and Stenting
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Autoren
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Henry Völzke
- Ernst-Moritz-Arndt-Universität, Greifswald
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Julia Henzler
- Ernst-Moritz-Arndt-Universität, Greifswald
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Dirk Menzel
- Herz- und Diabeteszentrum, Karlsburg
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Wolfgang Hoffmann
- Ernst-Moritz-Arndt-Universität, Greifswald
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Ulrich John
- Ernst-Moritz-Arndt-Universität, Griefswald
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Rainer Rettig
- Ernst-Moritz-Arndt-Universität, Greifswald
| Veröffentlicht: | 8. September 2005 |
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Gliederung
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Introduction and Aims
While there is evidence for a better short-term outcome in CS patients compared to patients who received plain balloon angioplasty, little information is currently available with respect to the long-term outcome after CS. Information on the outcome after CS compared to the outcome after coronary artery bypass graft (CABG) surgery is likewise sparse. The aim of this study was to investigate the long-term prognosis after balloon angioplasty (PTCA), coronary stenting (CS) and coronary artery bypass grafting (CABG).
Methods
A number of 1038 patients with PTCA (n= 499), CS (n= 294) or CABG (n= 245) were followed-up over a mean time of 6.4±1.8 years. Forty-two patients (4.0%) were lost to follow-up leaving a study population of 996 subjects who were available for analyses. The primary and secondary endpoints were mortality and major adverse cardiac events (MACE), respectively.
Results
Overall death proportion was 19.3%. Age, pulse pressure, smoking, diabetes, serum LDL cholesterol levels and left ventricular ejection fraction rather than the intervention type independently predicted mortality. The incidence rate of MACE was 53.7%. Compared to PTCA patients, CS patients had lower (hazard ratio 0.693; 95%-confidence interval 0.514-0.793) and CABG patients the lowest risk of MACE (hazard ratio 0.343; 95%-confidence interval 0.261-0.450). Further risk factors for MACE were serum LDL cholesterol levels, three-vessel coronary artery disease and left ventricular ejection fraction of <30%.
Conclusion
Long-term mortality does not differ among patients who received percutaneous interventions or CABG. Major adverse cardiac events occur more often in patients with previous percutaneous interventions, whereby CS has advantage over PTCA.
