دورية أكاديمية
Impact of on-pump and off-pump coronary artery bypass grafting on 10-year mortality versus percutaneous coronary intervention
| العنوان: | Impact of on-pump and off-pump coronary artery bypass grafting on 10-year mortality versus percutaneous coronary intervention |
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| المؤلفون: | Colombo, Antonio |
| المساهمون: | Kageyama, Shigetaka, Serruys, Patrick W, Ninomiya, Kai, O'Leary, Neil, Masuda, Shinichiro, Kotoku, Nozomi, Colombo, Antonio, van Geuns, Robert-Jan, Milojevic, Milan, Mack, Michael J, Soo, Alan, Garg, Scot, Onuma, Yoshinobu, Davierwala, Piroze M |
| بيانات النشر: | OXFORD UNIV PRESS INC |
| سنة النشر: | 2023 |
| المجموعة: | Università Cattolica del Sacro Cuore: PubliCatt |
| مصطلحات موضوعية: | Complex coronary artery disease, Coronary artery bypass grafting, Percutaneous coronary intervention, Revascularization, Ten-year mortality, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE |
| الوصف: | OBJECTIVES: The very long-term mortality of off-pump and on-pump coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in a randomized complex coronary artery disease population is unknown. This study aims to investigate the impact of on-pump and off-pump CABG versus PCI on 10-year all-cause mortality. METHODS: The SYNTAX trial randomized 1800 patients with three-vessel and/or left main coronary artery disease to PCI or CABG and assessed their survival at 10 years. In this sub-study, the hazard of mortality over 10 years was compared according to the technique of revascularization: on-pump CABG (n = 725), off-pump CABG (n = 128) and PCI (n = 903). RESULTS: There was substantial inter-site variation in the use of off-pump CABG despite baseline characteristics being largely homogeneous among the 3 groups. The crude rate of mortality was significantly lower following on-pump CABG versus PCI [25.6% vs 28.4%, hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.65-0.96], while it was comparable between off-pump CABG and PCI (28.5% vs 28.4%, HR 0.98, 95% CI 0.69-1.40). After adjusting for the 9 variables included in the SYNTAX score II 2020, 10-year mortality remained significantly lower with on-pump CABG than PCI (HR 0.75 against PCI, P= 0.009). CONCLUSIONS: In the SYNTAXES trial, 10-year mortality adjusted for major confounders was significantly lower following on-pump CABG compared to PCI. There was no evidence for unadjusted difference between off-pump CABG and PCI, although the unadjusted estimated HR had a wide CI. Site heterogeneity in the technique used in bypass surgery has had measurable effects on treatment performance. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/37348857; info:eu-repo/semantics/altIdentifier/wos/WOS:001044959700004; volume:64; issue:2; firstpage:N/A; lastpage:N/A; issueyear:2023; journal:EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY; https://hdl.handle.net/10807/249016Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85167482290 |
| DOI: | 10.1093/ejcts/ezad240 |
| الإتاحة: | https://doi.org/10.1093/ejcts/ezad240Test https://hdl.handle.net/10807/249016Test |
| رقم الانضمام: | edsbas.436A1654 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/ejcts/ezad240 |
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