Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery

Shaoping Wang,1,2 Yi Lyu,3 Shujuan Cheng,1 Jinghua Liu,1 Bijan J Borah2,4 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA; 3Department of Anesthesiology, M...

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Autores principales:	Wang S, Lyu Y, Cheng S, Liu J, Borah BJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	bypass ejection fraction heart failure revascularization stents Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/a27e64d70e014ae397d996c3d8665235
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spelling	oai:doaj.org-article:a27e64d70e014ae397d996c3d86652352021-12-02T17:57:53ZClinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery1178-203Xhttps://doaj.org/article/a27e64d70e014ae397d996c3d86652352021-10-01T00:00:00Zhttps://www.dovepress.com/clinical-outcomes-of-patients-with-coronary-artery-diseases-and-modera-peer-reviewed-fulltext-article-TCRMhttps://doaj.org/toc/1178-203XShaoping Wang,1,2 Yi Lyu,3 Shujuan Cheng,1 Jinghua Liu,1 Bijan J Borah2,4 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA; 3Department of Anesthesiology, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 4Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USACorrespondence: Bijan J BorahDepartment of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USAEmail borah.bijan@mayo.eduJinghua LiuDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, People’s Republic of ChinaTel/Fax +86 10 64456998Email liujinghua@vip.sina.comPurpose: Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are two revascularization strategies for patients with coronary artery disease (CAD) and left ventricular dysfunction. However, the comparisons of effectiveness between the two strategies are insufficient. This study is aimed to compare the effectiveness between PCI and CABG among patients with moderate left ventricular dysfunction.Patients and Methods: A total of 1487 CAD patients with moderate reduced ejection fraction (36%≤EF≤ 40%), who underwent either PCI or CABG, were enrolled in a real-world cohort study (No. ChiCTR2100044378). Clinical outcomes included short- and long-term all-cause mortality, rates of heart failure (HF) hospitalization and repeat revascularization. Propensity score matching was used to balance the two cohorts.Results: PCI was associated with lower 30-day mortality rate (hazard ratio [HR] [95% CI], 0.35 [0.15– 0.83]; P=0.02). At a mean follow-up of 4.5 years, PCI and CABG had similar all-cause death (HR [95% CI], 0.82 [0.56– 1.20]; P=0.30) and heart failure (HF) hospitalization (HR [95% CI], 0.93 [0.54– 1.60]; P=0.79), but PCI had higher risk of repeat revascularization (HR [95% CI], 8.62 [3.67– 20.23]; P< 0.001). Improvement in EF measured at 3 months later after revascularization was also similar between PCI and CABG (P for interaction=0.87).Conclusion: CAD patients with moderate reduced EF who had PCI had lower short-term mortality rate but higher risk of repeat revascularization during follow-up than patients who had CABG. PCI showed comparable long-term survival, HF hospitalization risk, and EF improvement.Keywords: bypass, ejection fraction, heart failure, revascularization, stentsWang SLyu YCheng SLiu JBorah BJDove Medical Pressarticlebypassejection fractionheart failurerevascularizationstentsTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 17, Pp 1103-1111 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bypass ejection fraction heart failure revascularization stents Therapeutics. Pharmacology RM1-950
spellingShingle	bypass ejection fraction heart failure revascularization stents Therapeutics. Pharmacology RM1-950 Wang S Lyu Y Cheng S Liu J Borah BJ Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery
description	Shaoping Wang,1,2 Yi Lyu,3 Shujuan Cheng,1 Jinghua Liu,1 Bijan J Borah2,4 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA; 3Department of Anesthesiology, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 4Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USACorrespondence: Bijan J BorahDepartment of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USAEmail borah.bijan@mayo.eduJinghua LiuDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, People’s Republic of ChinaTel/Fax +86 10 64456998Email liujinghua@vip.sina.comPurpose: Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are two revascularization strategies for patients with coronary artery disease (CAD) and left ventricular dysfunction. However, the comparisons of effectiveness between the two strategies are insufficient. This study is aimed to compare the effectiveness between PCI and CABG among patients with moderate left ventricular dysfunction.Patients and Methods: A total of 1487 CAD patients with moderate reduced ejection fraction (36%≤EF≤ 40%), who underwent either PCI or CABG, were enrolled in a real-world cohort study (No. ChiCTR2100044378). Clinical outcomes included short- and long-term all-cause mortality, rates of heart failure (HF) hospitalization and repeat revascularization. Propensity score matching was used to balance the two cohorts.Results: PCI was associated with lower 30-day mortality rate (hazard ratio [HR] [95% CI], 0.35 [0.15– 0.83]; P=0.02). At a mean follow-up of 4.5 years, PCI and CABG had similar all-cause death (HR [95% CI], 0.82 [0.56– 1.20]; P=0.30) and heart failure (HF) hospitalization (HR [95% CI], 0.93 [0.54– 1.60]; P=0.79), but PCI had higher risk of repeat revascularization (HR [95% CI], 8.62 [3.67– 20.23]; P< 0.001). Improvement in EF measured at 3 months later after revascularization was also similar between PCI and CABG (P for interaction=0.87).Conclusion: CAD patients with moderate reduced EF who had PCI had lower short-term mortality rate but higher risk of repeat revascularization during follow-up than patients who had CABG. PCI showed comparable long-term survival, HF hospitalization risk, and EF improvement.Keywords: bypass, ejection fraction, heart failure, revascularization, stents
format	article
author	Wang S Lyu Y Cheng S Liu J Borah BJ
author_facet	Wang S Lyu Y Cheng S Liu J Borah BJ
author_sort	Wang S
title	Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery
title_short	Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery
title_full	Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery
title_fullStr	Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery
title_full_unstemmed	Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery
title_sort	clinical outcomes of patients with coronary artery diseases and moderate left ventricular dysfunction: percutaneous coronary intervention versus coronary artery bypass graft surgery
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/a27e64d70e014ae397d996c3d8665235
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Clinical Outcomes of Patients with Coronary Artery Diseases and Moderate Left Ventricular Dysfunction: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery

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