Long-term mortality of coronary artery bypass grafting and bare-metal stenting

Chuntao Wu, Songyang Zhao, Andrew S. Wechsler, Stephen Lahey, Gary Walford, Alfred T. Culliford, Jeffrey P Gold, Craig R. Smith, David R. Holmes, Spencer B. King, Robert S.D. Higgins, Desmond Jordan, Edward L. Hannan

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Abstract

Background: There is little information on relative survival with follow-up longer than 5 years in patients undergoing coronary artery bypass grafting (CABG) and patients undergoing percutaneous coronary intervention (PCI) with stenting. This study tested the hypothesis that CABG is associated with a lower risk of long-term (8-year) mortality than is stenting with bare-metal stents for multivessel coronary disease. Methods: We identified 18,359 patients with multivessel disease who underwent isolated CABG and 13,377 patients who received bare-metal stenting in 1999 to 2000 in New York and followed their vital status through 2007 using the National Death Index (NDI). We matched CABG and stent patients on the number of diseased coronary vessels, proximal left anterior descending (LAD) artery disease, and propensity of undergoing CABG based on numerous patient characteristics and compared survival after the 2 procedures. Results: In the 7,235 pairs of matched patients, the overall 8-year survival rates were 78.0% for CABG and 71.2% for stenting (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.64 to 0.74; p < 0.001). For anatomic groups classified by the number of diseased vessels and proximal LAD involvement, the HRs ranged from 0.53 (p < 0.001) for patients with 3-vessel disease involving proximal LAD artery disease to 0.78 (p = 0.05) for patients with 2-vessel disease but no disease in the LAD artery. A lower risk of death after CABG was observed in all subgroups stratified by a number of baseline risk factors. Conclusions: Coronary artery bypass grafting is associated with a lower risk of death than is stenting with bare metal stents for multivessel coronary disease.

Original languageEnglish (US)
Pages (from-to)2132-2138
Number of pages7
JournalAnnals of Thoracic Surgery
Volume92
Issue number6
DOIs
StatePublished - Jan 1 2011

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Coronary Artery Bypass
Metals
Mortality
Stents
Arteries
Coronary Disease
Survival
Percutaneous Coronary Intervention
Coronary Vessels
Survival Rate
Confidence Intervals

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Wu, C., Zhao, S., Wechsler, A. S., Lahey, S., Walford, G., Culliford, A. T., ... Hannan, E. L. (2011). Long-term mortality of coronary artery bypass grafting and bare-metal stenting. Annals of Thoracic Surgery, 92(6), 2132-2138. https://doi.org/10.1016/j.athoracsur.2011.06.061

Long-term mortality of coronary artery bypass grafting and bare-metal stenting. / Wu, Chuntao; Zhao, Songyang; Wechsler, Andrew S.; Lahey, Stephen; Walford, Gary; Culliford, Alfred T.; Gold, Jeffrey P; Smith, Craig R.; Holmes, David R.; King, Spencer B.; Higgins, Robert S.D.; Jordan, Desmond; Hannan, Edward L.

In: Annals of Thoracic Surgery, Vol. 92, No. 6, 01.01.2011, p. 2132-2138.

Research output: Contribution to journalArticle

Wu, C, Zhao, S, Wechsler, AS, Lahey, S, Walford, G, Culliford, AT, Gold, JP, Smith, CR, Holmes, DR, King, SB, Higgins, RSD, Jordan, D & Hannan, EL 2011, 'Long-term mortality of coronary artery bypass grafting and bare-metal stenting', Annals of Thoracic Surgery, vol. 92, no. 6, pp. 2132-2138. https://doi.org/10.1016/j.athoracsur.2011.06.061
Wu, Chuntao ; Zhao, Songyang ; Wechsler, Andrew S. ; Lahey, Stephen ; Walford, Gary ; Culliford, Alfred T. ; Gold, Jeffrey P ; Smith, Craig R. ; Holmes, David R. ; King, Spencer B. ; Higgins, Robert S.D. ; Jordan, Desmond ; Hannan, Edward L. / Long-term mortality of coronary artery bypass grafting and bare-metal stenting. In: Annals of Thoracic Surgery. 2011 ; Vol. 92, No. 6. pp. 2132-2138.
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abstract = "Background: There is little information on relative survival with follow-up longer than 5 years in patients undergoing coronary artery bypass grafting (CABG) and patients undergoing percutaneous coronary intervention (PCI) with stenting. This study tested the hypothesis that CABG is associated with a lower risk of long-term (8-year) mortality than is stenting with bare-metal stents for multivessel coronary disease. Methods: We identified 18,359 patients with multivessel disease who underwent isolated CABG and 13,377 patients who received bare-metal stenting in 1999 to 2000 in New York and followed their vital status through 2007 using the National Death Index (NDI). We matched CABG and stent patients on the number of diseased coronary vessels, proximal left anterior descending (LAD) artery disease, and propensity of undergoing CABG based on numerous patient characteristics and compared survival after the 2 procedures. Results: In the 7,235 pairs of matched patients, the overall 8-year survival rates were 78.0{\%} for CABG and 71.2{\%} for stenting (hazard ratio [HR], 0.68; 95{\%} confidence interval [CI], 0.64 to 0.74; p < 0.001). For anatomic groups classified by the number of diseased vessels and proximal LAD involvement, the HRs ranged from 0.53 (p < 0.001) for patients with 3-vessel disease involving proximal LAD artery disease to 0.78 (p = 0.05) for patients with 2-vessel disease but no disease in the LAD artery. A lower risk of death after CABG was observed in all subgroups stratified by a number of baseline risk factors. Conclusions: Coronary artery bypass grafting is associated with a lower risk of death than is stenting with bare metal stents for multivessel coronary disease.",
author = "Chuntao Wu and Songyang Zhao and Wechsler, {Andrew S.} and Stephen Lahey and Gary Walford and Culliford, {Alfred T.} and Gold, {Jeffrey P} and Smith, {Craig R.} and Holmes, {David R.} and King, {Spencer B.} and Higgins, {Robert S.D.} and Desmond Jordan and Hannan, {Edward L.}",
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AU - Wu, Chuntao

AU - Zhao, Songyang

AU - Wechsler, Andrew S.

AU - Lahey, Stephen

AU - Walford, Gary

AU - Culliford, Alfred T.

AU - Gold, Jeffrey P

AU - Smith, Craig R.

AU - Holmes, David R.

AU - King, Spencer B.

AU - Higgins, Robert S.D.

AU - Jordan, Desmond

AU - Hannan, Edward L.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: There is little information on relative survival with follow-up longer than 5 years in patients undergoing coronary artery bypass grafting (CABG) and patients undergoing percutaneous coronary intervention (PCI) with stenting. This study tested the hypothesis that CABG is associated with a lower risk of long-term (8-year) mortality than is stenting with bare-metal stents for multivessel coronary disease. Methods: We identified 18,359 patients with multivessel disease who underwent isolated CABG and 13,377 patients who received bare-metal stenting in 1999 to 2000 in New York and followed their vital status through 2007 using the National Death Index (NDI). We matched CABG and stent patients on the number of diseased coronary vessels, proximal left anterior descending (LAD) artery disease, and propensity of undergoing CABG based on numerous patient characteristics and compared survival after the 2 procedures. Results: In the 7,235 pairs of matched patients, the overall 8-year survival rates were 78.0% for CABG and 71.2% for stenting (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.64 to 0.74; p < 0.001). For anatomic groups classified by the number of diseased vessels and proximal LAD involvement, the HRs ranged from 0.53 (p < 0.001) for patients with 3-vessel disease involving proximal LAD artery disease to 0.78 (p = 0.05) for patients with 2-vessel disease but no disease in the LAD artery. A lower risk of death after CABG was observed in all subgroups stratified by a number of baseline risk factors. Conclusions: Coronary artery bypass grafting is associated with a lower risk of death than is stenting with bare metal stents for multivessel coronary disease.

AB - Background: There is little information on relative survival with follow-up longer than 5 years in patients undergoing coronary artery bypass grafting (CABG) and patients undergoing percutaneous coronary intervention (PCI) with stenting. This study tested the hypothesis that CABG is associated with a lower risk of long-term (8-year) mortality than is stenting with bare-metal stents for multivessel coronary disease. Methods: We identified 18,359 patients with multivessel disease who underwent isolated CABG and 13,377 patients who received bare-metal stenting in 1999 to 2000 in New York and followed their vital status through 2007 using the National Death Index (NDI). We matched CABG and stent patients on the number of diseased coronary vessels, proximal left anterior descending (LAD) artery disease, and propensity of undergoing CABG based on numerous patient characteristics and compared survival after the 2 procedures. Results: In the 7,235 pairs of matched patients, the overall 8-year survival rates were 78.0% for CABG and 71.2% for stenting (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.64 to 0.74; p < 0.001). For anatomic groups classified by the number of diseased vessels and proximal LAD involvement, the HRs ranged from 0.53 (p < 0.001) for patients with 3-vessel disease involving proximal LAD artery disease to 0.78 (p = 0.05) for patients with 2-vessel disease but no disease in the LAD artery. A lower risk of death after CABG was observed in all subgroups stratified by a number of baseline risk factors. Conclusions: Coronary artery bypass grafting is associated with a lower risk of death than is stenting with bare metal stents for multivessel coronary disease.

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