Long-Term Mortality in Ischemic HF Patients With PCI vs. CAB
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This study aimed to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of patients with heart failure due to ischaemic heart disease.

Researchers analysed all-cause mortality following CABG or PCI in patients with heart failure with reduced ejection fraction and multivessel disease (coronary artery stenosis more than 50% in 2 vessels or left main) who underwent coronary angiography between 2000 and 2018 in Sweden. They used a propensity score-adjusted logistic and Cox proportional-hazards regressions and instrumental variable model to adjust for known and unknown confounders.

Multilevel modelling was used to adjust for the clustering of observations in a hierarchical database. In total, 2509 patients (82.9% men) were included; 35.8% had diabetes and 34.7% had a previous myocardial infarction. The mean age was 68.1?±?9.4?years (47.8% were more than 70?years old), and 64.9% had three-vessel or left main disease. Primary designated therapy was PCI in 56.2% and CABG in 43.8%.

Median follow-up time was 3.9?years (range 1 day to 10?years). There were 1010 deaths. Risk of death was lower after CABG than after PCI. The risk of death increased linearly with quintiles of hospitals in which PCI was the preferred method for revascularization.

Conclusively, in patients with ischaemic heart failure, long-term survival was greater after CABG than after PCI.

Source: https://academic.oup.com/eurheartj/article/42/27/2657/6282431