Journals / Koşuyolu Heart Journal / 2013 / Cilt: 16 - Sayı: 2

Comparison of Clinical Outcomes in Patients Who Underwent Bare Metal Coronary Stenting Versus Coronary By-pass Surgery

Koroner Baypas Cerrahisi ve Çıplak Metal Stent Uygulanan Hastaların Klinik Sonlanımlarının Karşılaştırılması

Pages
99–106
Publication Date
2012-02-01
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Results: Throughout the study, the intermediate-term incidence of any revascularization was signifi cantly higher in the percutaneous coronary intervention group compared with the coronary bypass grafting group for both overall group and Sx tertiles.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: We aimed to compare the effects of coronary lesion complexity assessed by SYNTAX (Sx) score on the clinical outcomes in patients who have received BMS versus undergone coronary bypass grafting.
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Key Findings & Data:Patients and Methods: Our study population consisted of 459 consecutive patients received bare metal stents (n= 265) or coronary bypass grafting (n= 294).
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Conclusion & Impact:Results: Throughout the study, the intermediate-term incidence of any revascularization was signifi cantly higher in the percutaneous coronary intervention group compared with the coronary bypass grafting group for both overall group and Sx tertiles.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Koroner arter baypas · stentler · perkütan koroner girişim.

Abstract

Introduction: We aimed to compare the effects of coronary lesion complexity assessed by SYNTAX (Sx) score on the clinical outcomes in patients who have received BMS versus undergone coronary bypass grafting. Patients and Methods: Our study population consisted of 459 consecutive patients received bare metal stents (n= 265) or coronary bypass grafting (n= 294). The complexity of coronary artery disease was assessed by Sx score. Sx score was classifi ed as tertiles, as follows: low Sx score (? 22), intermediate Sx score (23-32) and high Sx score (? 33). Results: Throughout the study, the intermediate-term incidence of any revascularization was signifi cantly higher in the percutaneous coronary intervention group compared with the coronary bypass grafting group for both overall group and Sx tertiles. The intermediate-term incidence of death from any cause was comparable between the treatment groups in patients with low and intermediate Sx tertiles. However, in patients with high Sx tertile, the intermediate-term incidence of death from any cause was signifi cantly higher in percutaneous coronary intervention group compared with coronary bypass grafting group. In the overall population, adjusted [hazard ratio, 95% CI: 0.88 (0.38-2.05), p= 0.780) risks for death from any cause were consistently comparable between percutaneous coronary intervention and coronary bypass grafting, whereas adjusted [hazard ratio, 95% CI: 0.12 (0.05-0.30), p< 0.001] risks for any revascularization were consistently signifi cantly higher in the percutaneous coronary intervention group compared with coronary bypass grafting group.Conclusion: Coronary lesion complexity assessed by SYNTAX score was closely associated with the higher incidence of any revascularization and in high SYNTAX score, with higher incidence of death from any cause in patients received bare metal stents than coronary artery bypass grafting.

Özet

Giriş: Biz bu çalışmamızda, koroner baypas greftleme cerrahisi ile çıplak metal stent uygulanmış hastalarda SYNTAX (Sx) skoru ile değerlendirilen koroner lezyon kompleksitelerinin klinik sonlanımlar üzerine etkisini incelemeyi amaçladık. Hastalar ve Yöntem: Çalışma grubumuz çıplak metal stent uygulanmış (n= 265) ve koroner baypas cerrahisine giden (n= 294) 459 hastadan oluşmaktadır. Koroner arter hastalığı kompleksitesi Sx skoru ile değerlendirilmiştir. Sx skoru, hafi f Sx skoru (? 22), orta Sx skoru (23-32) ve yüksek Sx skoru (? 33) olmak üzere üç gruba ayrılmıştır. Bulgular: Çalışma süresince orta dönem takipte herhangi bir nedenle revaskülarizasyon sıklığı hem tüm grupta hem de Sx alt gruplarında perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Orta dönem takipte herhangi bir nedenden ölüm sıklığı düşük ve orta Sx gruplarında tedavi grupları arasında benzer bulunmuştur. Ancak yüksek Sx skoru grubunda orta dönem takipte herhangi bir nedenden ölüm sıklığı perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Tüm popülasyonda herhangi bir nedenden dolayı ölüm için düzeltilmiş risk perkütan koroner girişim ve koroner baypas cerrahisi arasında benzerken [hazard ratio, %95 GA: 0.88 (0.38-2.05), p= 0.780], herhangi bir nedenle revaskülarizasyon için düzeltilmiş risk koroner baypas cerrahisi grubuna göre perkütan koroner girişim grubunda belirgin olarak daha fazlaydı [hazard ratio, %95 GA: 0.12 (0.05-0.30), p< 0.001]. Sonuç: Sx skoru ile değerlendirilen koroner lezyon kompleksitesi herhangi bir nedenle revaskülarizasyon sıklığı ile daha yakın ilişkilidir. Yüksek Sx skoru gubunda herhangi bir nedenden ölüm çıplak metal stent uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazlaydı.

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Cite This Article

TANBOĞA, İ. H., KURT, M., AKSAKAL, E., KAYGIN, M. A., KAYA, A., IŞIK, T., ÇOLAK, A., SEVİMLİ, S. (2012). Comparison of Clinical Outcomes in Patients Who Underwent Bare Metal Coronary Stenting Versus Coronary By-pass Surgery. Koşuyolu Heart Journal, Cilt: 16 - Sayı: 2, 99–106. https://ajindex.com/articles/64045

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References (10)

  1. Silber S, Albertsson P, Aviles FF, Camici PG, Colombo A, Hamm C, et al. Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the Euro- pean Society of Cardiology. Eur Heart J 2005;26:804-47.
  2. Frutkin AD, Lindsey JB, Mehta SK, House JA, Spertus JA, Cohen DJ, et al. Drug-eluting stents and the use of percutaneous coro- nary intervention among patients with class I indications for co- ronary artery bypass surgery undergoing index revascularization: analysis from the NCDR (National Cardiovascular Data Registry). JACC Cardiovasc Interv 2009;2:614-21.
  3. Suleiman MS, Hancock M, Shukla R, Rajakaruna C, Angelini GD. Cardioplegic strategies to protect the hypertrophic heart during cardiac surgery. Perfusion 2011;26(Suppl 1):48-56.
  4. Elmistekawy EM, Rubens FD. Deep hypothermic circulatory ar- rest: alternative strategies for cerebral perfusion. A review article. Perfusion 2011;26(Suppl 1):27-34. SoS Investigators. Coronary artery bypass surgery versus percu- taneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the stent or surgery tri- al): a randomised controlled trial. Lancet 2002;360:965-70.
  5. Hueb W, Soares PR, Gersh BJ, Cesar LA, Luz PL, Puig LB, et al. The medicine, angioplasty, or surgery study (MASS-II): a rando- mized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results. J Am Coll Cardiol 2004;43:1743-51.
  6. Rodriguez A, Bernardi V, Navia J, Baldi J, Grinfeld L, Martinez J, et al. Argentine randomized study: coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple- vessel disease (ERACI II): 30-day and one-year follow-up results. ERACI II investigators. J Am Coll Cardiol 2001;37:51-8.
  7. Serruys PW, Unger F, Sousa JE, Jatene A, Bonnier HJ, Schonber- ger JP, et al. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease. N Engl J Med 2001;344:1117-24.
  8. Hannan EL, Wu C, Walford G, Culliford AT, Gold JP, Smith CR, et al. Drug-eluting stents vs. coronary-artery bypass grafting in mul- tivessel coronary disease. N Engl J Med 2008;358:331-41.
  9. Li Y, Zheng Z, Xu B, Zhang S, Li W, Gao R, et al. Comparison of drug-eluting stents and coronary artery bypass surgery for the treatment of multivessel coronary disease: three-year follow-up results from a single institution. Circulation 2009;119:2040-50.
  10. Serruys PW, Morice MC, Kappetein AP