Comparison of minimally invasive direct coronary artery bypass and percutaneous coronary intervention using second-generation drug-eluting stents for coronary artery disease: Propensity score-matched analysis

Research output: Contribution to journalArticle

Abstract

Background: Some studies comparing minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) have reported MIDCAB’s superiority, but they did not investigate contemporary PCI with newer generation drug-eluting stents (DES). We compared clinical outcomes after MIDCAB with previously reported outcomes after PCI with second-generation DES. Methods and Results: We retrospectively reviewed the records of patients treated with MIDCAB. Baseline characteristics and clinical outcomes after MIDCAB were compared with those for left anterior descending artery disease treated via PCI. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of cardiovascular death, non-fatal myocardial infarction, ischemic stroke, and target vessel revascularization (TVR). A propensity score-matching (PSM) analysis was conducted to adjust for between-group differences in baseline characteristics. We analyzed 77 patients treated with MIDCAB and 2,206 treated with PCI. The MIDCAB group was older and had more severe coronary disease and a higher incidence of left ventricular dysfunction. Over a 3-year follow-up, the PCI group had favorable MACCE outcomes. After PSM, there were no between-group differences in MACCE (MIDCAB, 15.6% vs. PCI, 23.4%; hazard ratio [HR], 0.80; 95% CI: 0.38–1.68, P=0.548) or TVR (MIDCAB, 2.6% vs. PCI, 5.2%; HR, 0.51; 95% CI: 0.10–3.09, P=0.509). Conclusions: Clinical outcomes were similar between MIDCAB and PCI using second-generation DES over 3 years of follow-up.

Original languageEnglish
Pages (from-to)1572-1580
Number of pages9
JournalCirculation Journal
Volume83
Issue number7
DOIs
StatePublished - 1 Jan 2019

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Propensity Score
Drug-Eluting Stents
Percutaneous Coronary Intervention
Coronary Artery Bypass
Coronary Artery Disease
Left Ventricular Dysfunction
Coronary Disease
Arteries
Stroke
Myocardial Infarction

Keywords

  • Drug-eluting stent
  • Minimally invasive direct coronary artery bypass
  • Percutaneous coronary intervention

Cite this

@article{a8c8c162df5049b287d2709f1918ebe0,
title = "Comparison of minimally invasive direct coronary artery bypass and percutaneous coronary intervention using second-generation drug-eluting stents for coronary artery disease: Propensity score-matched analysis",
abstract = "Background: Some studies comparing minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) have reported MIDCAB’s superiority, but they did not investigate contemporary PCI with newer generation drug-eluting stents (DES). We compared clinical outcomes after MIDCAB with previously reported outcomes after PCI with second-generation DES. Methods and Results: We retrospectively reviewed the records of patients treated with MIDCAB. Baseline characteristics and clinical outcomes after MIDCAB were compared with those for left anterior descending artery disease treated via PCI. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of cardiovascular death, non-fatal myocardial infarction, ischemic stroke, and target vessel revascularization (TVR). A propensity score-matching (PSM) analysis was conducted to adjust for between-group differences in baseline characteristics. We analyzed 77 patients treated with MIDCAB and 2,206 treated with PCI. The MIDCAB group was older and had more severe coronary disease and a higher incidence of left ventricular dysfunction. Over a 3-year follow-up, the PCI group had favorable MACCE outcomes. After PSM, there were no between-group differences in MACCE (MIDCAB, 15.6{\%} vs. PCI, 23.4{\%}; hazard ratio [HR], 0.80; 95{\%} CI: 0.38–1.68, P=0.548) or TVR (MIDCAB, 2.6{\%} vs. PCI, 5.2{\%}; HR, 0.51; 95{\%} CI: 0.10–3.09, P=0.509). Conclusions: Clinical outcomes were similar between MIDCAB and PCI using second-generation DES over 3 years of follow-up.",
keywords = "Drug-eluting stent, Minimally invasive direct coronary artery bypass, Percutaneous coronary intervention",
author = "Wonsuk Choi and Chang, {Hyoung Woo} and Kang, {Si Hyuck} and Yoon, {Chang Hwan} and Cho, {Young Seok} and Youn, {Tae Jin} and Chae, {In Ho} and Kim, {Dong Jung} and Kim, {Jun Sung} and Park, {Kay Hyun} and Kim, {Hyo Soo} and Cheong Lim and Suh, {Jung Won}",
year = "2019",
month = "1",
day = "1",
doi = "10.1253/circj.CJ-18-1330",
language = "English",
volume = "83",
pages = "1572--1580",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "7",

}

TY - JOUR

T1 - Comparison of minimally invasive direct coronary artery bypass and percutaneous coronary intervention using second-generation drug-eluting stents for coronary artery disease

T2 - Propensity score-matched analysis

AU - Choi, Wonsuk

AU - Chang, Hyoung Woo

AU - Kang, Si Hyuck

AU - Yoon, Chang Hwan

AU - Cho, Young Seok

AU - Youn, Tae Jin

AU - Chae, In Ho

AU - Kim, Dong Jung

AU - Kim, Jun Sung

AU - Park, Kay Hyun

AU - Kim, Hyo Soo

AU - Lim, Cheong

AU - Suh, Jung Won

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Some studies comparing minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) have reported MIDCAB’s superiority, but they did not investigate contemporary PCI with newer generation drug-eluting stents (DES). We compared clinical outcomes after MIDCAB with previously reported outcomes after PCI with second-generation DES. Methods and Results: We retrospectively reviewed the records of patients treated with MIDCAB. Baseline characteristics and clinical outcomes after MIDCAB were compared with those for left anterior descending artery disease treated via PCI. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of cardiovascular death, non-fatal myocardial infarction, ischemic stroke, and target vessel revascularization (TVR). A propensity score-matching (PSM) analysis was conducted to adjust for between-group differences in baseline characteristics. We analyzed 77 patients treated with MIDCAB and 2,206 treated with PCI. The MIDCAB group was older and had more severe coronary disease and a higher incidence of left ventricular dysfunction. Over a 3-year follow-up, the PCI group had favorable MACCE outcomes. After PSM, there were no between-group differences in MACCE (MIDCAB, 15.6% vs. PCI, 23.4%; hazard ratio [HR], 0.80; 95% CI: 0.38–1.68, P=0.548) or TVR (MIDCAB, 2.6% vs. PCI, 5.2%; HR, 0.51; 95% CI: 0.10–3.09, P=0.509). Conclusions: Clinical outcomes were similar between MIDCAB and PCI using second-generation DES over 3 years of follow-up.

AB - Background: Some studies comparing minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) have reported MIDCAB’s superiority, but they did not investigate contemporary PCI with newer generation drug-eluting stents (DES). We compared clinical outcomes after MIDCAB with previously reported outcomes after PCI with second-generation DES. Methods and Results: We retrospectively reviewed the records of patients treated with MIDCAB. Baseline characteristics and clinical outcomes after MIDCAB were compared with those for left anterior descending artery disease treated via PCI. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), a composite of cardiovascular death, non-fatal myocardial infarction, ischemic stroke, and target vessel revascularization (TVR). A propensity score-matching (PSM) analysis was conducted to adjust for between-group differences in baseline characteristics. We analyzed 77 patients treated with MIDCAB and 2,206 treated with PCI. The MIDCAB group was older and had more severe coronary disease and a higher incidence of left ventricular dysfunction. Over a 3-year follow-up, the PCI group had favorable MACCE outcomes. After PSM, there were no between-group differences in MACCE (MIDCAB, 15.6% vs. PCI, 23.4%; hazard ratio [HR], 0.80; 95% CI: 0.38–1.68, P=0.548) or TVR (MIDCAB, 2.6% vs. PCI, 5.2%; HR, 0.51; 95% CI: 0.10–3.09, P=0.509). Conclusions: Clinical outcomes were similar between MIDCAB and PCI using second-generation DES over 3 years of follow-up.

KW - Drug-eluting stent

KW - Minimally invasive direct coronary artery bypass

KW - Percutaneous coronary intervention

UR - http://www.scopus.com/inward/record.url?scp=85068606279&partnerID=8YFLogxK

U2 - 10.1253/circj.CJ-18-1330

DO - 10.1253/circj.CJ-18-1330

M3 - Article

C2 - 31130585

AN - SCOPUS:85068606279

VL - 83

SP - 1572

EP - 1580

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 7

ER -