Comparison of three treatment strategies for patients with triple-vessel coronary disease and left ventricular dysfunction

Journal of Interventional Cardiology
Lin JiangJin-Qing Yuan

Abstract

Current guidelines recommend coronary artery bypass grafting (CABG) for patients with multivessel coronary disease and left ventricular (LV) dysfunction. However, some patients undergo percutaneous coronary intervention (PCI) or solely medical therapy (MT) in actual practice. The comparison of long-term outcomes of these three treatment strategies in real world is unclear. A total of 699 consecutive patients in a single centre from 2004 to 2011 who had TVD and LV ejection fraction ≤40%, no prior PCI or CABG and had completed a median 6.2-year follow-up were evaluated. The primary endpoint was all-cause death. The secondary endpoints included cardiac death, major adverse cardiovascular and cerebrovascular events (MACCE; composite of all-cause death, myocardial infarction, repeat revascularization, or stroke), and the individual components of the composite endpoint. One hundred forty-two patients (20.3%) underwent PCI, 201 (28.8%) underwent CABG while 356 (50.9%) received MT alone. MT alone was associated with the worst survival (P < 0.001). Compared with PCI, CABG was associated with a similar risk of all-cause death (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.52-1.41; P = 0.54) but lower risks of cardiac death (HR...Continue Reading

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Apr 25, 2018·Minerva cardioangiologica·Piergiorgio BrunoMassimo Massetti
Aug 9, 2019·Current Opinion in Cardiology·Bobby YanagawaSubodh Verma
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