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Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease

BACKGROUND: The most prevalent illness among the elderly is coronary artery disease (CAD), and most of this population present with multi-vessel CAD which constitutes a common management difficulty among elderly people. This study aimed to compare long-term consequences of percutaneous coronary inte...

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Autores principales: Kamal, Amr, Kandil, Abdel Megeid, Sadaka, Mohamed, Ramadan, Basem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797625/
https://www.ncbi.nlm.nih.gov/pubmed/36576658
http://dx.doi.org/10.1186/s43044-022-00323-4
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author Kamal, Amr
Kandil, Abdel Megeid
Sadaka, Mohamed
Ramadan, Basem
author_facet Kamal, Amr
Kandil, Abdel Megeid
Sadaka, Mohamed
Ramadan, Basem
author_sort Kamal, Amr
collection PubMed
description BACKGROUND: The most prevalent illness among the elderly is coronary artery disease (CAD), and most of this population present with multi-vessel CAD which constitutes a common management difficulty among elderly people. This study aimed to compare long-term consequences of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) revascularization in elderly patients with multi-vessel coronary artery disease. RESULTS: This retrospective study evaluated 100 elderly patients with multi-vessel CAD divided into two groups, group 1 the PCI group and group 2 the CABG group. The main findings of the study showed that CABG group had a longer hospital stay than the PCI group (8.16 vs. 2.02 days; P < 0.001). A considerably higher mean residual SYNTAX score was observed in the PCI group than CABG group which was 1.15 and 0.2, respectively (p-value < 0.001). The in-hospital major adverse cardiac events rate (MACE) in both groups was not statistically significant. Regarding the in-hospital mortality rate, although it was higher in the CABG group (6%) versus 2% in the PCI group, yet it was not statistically significant. The long-term MACE in this study revealed that 12.2% of PCI patients had heart failure compared to 6.4% in the CABG group, which was statistically insignificant. In the long-term follow-up, the revascularization rate of CABG group was higher than the PCI group; however, it was statistically insignificant. CABG group had a higher rate of stroke than PCI group being 4.3% and 2%, respectively; yet this difference was not statistically considerable. The long-term mortality rate among the PCI and CABG group was 10.2% and 4.3%, respectively. CONCLUSIONS: Elderly patients with multi-vessel CAD, PCI with stenting, and CABG were statistically equivalent in long-term death and MI rates, stroke, repeat revascularization. A non-statistically notable distinction between the two groups as regards MACE, composite of death or MI, and all-cause mortality was found. This may have implication on choice of management strategy among elderly patients with multi-vessel CAD.
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spelling pubmed-97976252023-01-17 Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease Kamal, Amr Kandil, Abdel Megeid Sadaka, Mohamed Ramadan, Basem Egypt Heart J Research BACKGROUND: The most prevalent illness among the elderly is coronary artery disease (CAD), and most of this population present with multi-vessel CAD which constitutes a common management difficulty among elderly people. This study aimed to compare long-term consequences of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) revascularization in elderly patients with multi-vessel coronary artery disease. RESULTS: This retrospective study evaluated 100 elderly patients with multi-vessel CAD divided into two groups, group 1 the PCI group and group 2 the CABG group. The main findings of the study showed that CABG group had a longer hospital stay than the PCI group (8.16 vs. 2.02 days; P < 0.001). A considerably higher mean residual SYNTAX score was observed in the PCI group than CABG group which was 1.15 and 0.2, respectively (p-value < 0.001). The in-hospital major adverse cardiac events rate (MACE) in both groups was not statistically significant. Regarding the in-hospital mortality rate, although it was higher in the CABG group (6%) versus 2% in the PCI group, yet it was not statistically significant. The long-term MACE in this study revealed that 12.2% of PCI patients had heart failure compared to 6.4% in the CABG group, which was statistically insignificant. In the long-term follow-up, the revascularization rate of CABG group was higher than the PCI group; however, it was statistically insignificant. CABG group had a higher rate of stroke than PCI group being 4.3% and 2%, respectively; yet this difference was not statistically considerable. The long-term mortality rate among the PCI and CABG group was 10.2% and 4.3%, respectively. CONCLUSIONS: Elderly patients with multi-vessel CAD, PCI with stenting, and CABG were statistically equivalent in long-term death and MI rates, stroke, repeat revascularization. A non-statistically notable distinction between the two groups as regards MACE, composite of death or MI, and all-cause mortality was found. This may have implication on choice of management strategy among elderly patients with multi-vessel CAD. Springer Berlin Heidelberg 2022-12-28 /pmc/articles/PMC9797625/ /pubmed/36576658 http://dx.doi.org/10.1186/s43044-022-00323-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Kamal, Amr
Kandil, Abdel Megeid
Sadaka, Mohamed
Ramadan, Basem
Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
title Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
title_full Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
title_fullStr Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
title_full_unstemmed Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
title_short Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
title_sort long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797625/
https://www.ncbi.nlm.nih.gov/pubmed/36576658
http://dx.doi.org/10.1186/s43044-022-00323-4
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