One of the leading causes of heart failure (HF) is ischemic heart disease (IHD), which accounts for roughly two-thirds of all HF cases. Various randomized controlled trials have shown that coronary artery bypass grafting (CABG) improves long-term survival over OMT alone. However, the effects of percutaneous coronary intervention (PCI) in patients with HF and concomitant MVD have not been studied in a randomized setting. 

In light of this issue, Elmir Omerovic of the University of Gothenburg in Gothenburg, Sweden, and colleagues conducted a study to compare the efficacy of coronary artery bypass grafting and percutaneous coronary intervention for the treatment of patients with ischemic heart disease related heart failure.

Methodology:

The study included all patients who underwent coronary angiography in Sweden between 1 January 2000 and 31 March 2018, with the primary indication of HF and concomitant MVD (coronary artery stenosis >50% in 2 vessels or the left main). The researchers looked at all-cause mortality in these patients after coronary artery bypass grafting (CABG) or PCI. The average duration of follow-up was 3.9 years (range: 1 day to 10 years).

Results:

A total of 2509 patients were enrolled in this study, of which 82.9% were men, 35.8% of them had diabetes, and 34.7% had a history of myocardial infarction. The average patient age was 8.1 ± 9.4 years (47.8% were >70 years old). Three-vessel or left main disease was present in 64.9% of them. The primary designated therapy was PCI and CABG in 56.2% and 43.8% of the patients, respectively. 

There were 1010 deaths (40.5%) during the study period. CABG was associated with a lower risk of death than PCI [odds ratio (OR) 0.62]. A linear increase in the risk of death was observed with quintiles of hospitals where PCI was the preferred method of revascularization (OR 1.27, 95 % CI 1.17–1.38, Ptrend < 0.001).

Conclusion:

Long-term survival after CABG was higher in patients with ischaemic heart failure than after PCI, according to the findings of this study.

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Keywords

Disease Condition,Therapeutic Modality,Coronary Artery Disease,Heart Failure,Cardiovascular Surgery,Interventional Cardiology,Ischemic Heart Disease,Bypass,Percutaneous Coronary Intervention

Source

https://medicaldialogues.in/cardiology-ctvs/news/cabg-better-than-pci-for-improving-long-term-survival-in-ischemic-hf-patients-study-80336

Tags

Disease Condition ,Therapeutic Modality ,Coronary Artery Disease,Heart Failure,Cardiovascular Surgery,Interventional Cardiology,Ischemic Heart Disease,Bypass,Percutaneous Coronary Intervention