Comparison of 30-Day and 5-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients Aged ≤50 Years (the Coronary aRtery diseAse in younG adultS Study)

被引：22

作者：

Biancari, Fausto ^{[1
]}

Gudbjartsson, Tomas ^{[3
]}

Heikkinen, Jouni ^{[1
]}

Anttila, Vesa ^{[1
]}

Makikallio, Timo ^{[2
]}

Jeppsson, Anders ^{[4
]}

Thimour-Bergstrom, Linda ^{[4
]}

Mignosa, Carmelo ^{[5
]}

Rubino, Antonino S. ^{[5
]}

Kuttila, Kari ^{[6
,7
]}

Gunn, Jarmo ^{[6
,7
]}

Wistbacka, Jan-Ola ^{[8
]}

Teittinen, Kari ^{[9
]}

Korpilahti, Kari ^{[10
]}

Onorati, Francesco ^{[11
]}

Faggian, Giuseppe ^{[11
]}

Vinco, Giulia ^{[12
]}

Vassanelli, Corrado ^{[12
]}

Ribichini, Flavio ^{[12
]}

Juvonen, Tatu ^{[1
]}

Axelsson, Tomas A. ^{[3
]}

Sigurdsson, Axel F. ^{[13
]}

Karjalainen, Pasi P. ^{[14
]}

Mennander, Ari ^{[15
]}

Kajander, Olli ^{[15
]}

Eskola, Markku ^{[15
]}

Ilveskoski, Erkki ^{[15
]}

D'Oria, Veronica ^{[16
]}

De Feo, Marisa ^{[16
]}

Kiviniemi, Tuomas ^{[6
,7
]}

Airaksinen, K. E. Juhani ^{[6
,7
]}

机构：

[1] Oulu Univ Hosp, Dept Surg, Oulu, Finland

[2] Oulu Univ Hosp, Dept Internal Med, Oulu, Finland

[3] Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland

[4] Sahlgrens Univ Hosp, Dept Cardiothorac Surg, Gothenburg, Sweden

[5] Univ Catania, Policlin Vittorio Emanuele, AOU, Cardiac Surg Unit, Catania, Italy

[6] Turku Univ Hosp, Ctr Heart, FIN-20520 Turku, Finland

[7] Univ Turku, Turku, Finland

[8] Vaasa Cent Hosp, Dept Anesthesiol, Vaasa, Finland

[9] Vaasa Cent Hosp, Dept Surg, Vaasa, Finland

[10] Vaasa Cent Hosp, Dept Internal Med, Vaasa, Finland

[11] Univ Verona, Sch Med, Div Cardiac Surg, I-37100 Verona, Italy

[12] Univ Verona, Sch Med, Dept Med, Div Cardiol, I-37100 Verona, Italy

[13] Univ Iceland, Fac Med, Dept Cardiol, Reykjavik, Iceland

[14] Satakunta Cent Hosp, Ctr Heart, Pori, Finland

[15] Tampere Univ Hosp, Ctr Heart, Tampere, Finland

[16] V Monaldi Hosp, Dept Cardiothorac & Resp Sci, Naples, Italy

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2014年 / 114卷 / 02期

关键词：

PATIENTS LESS-THAN-40 YEARS; ASSOCIATION TASK-FORCE; TERM-FOLLOW-UP; ACCF/AHA GUIDELINE; SURGERY; ANGIOPLASTY; SURVIVAL;

D O I：

10.1016/j.amjcard.2014.04.025

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Data on the outcome of young patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are scarce. Data on 2,209 consecutive patients aged 550 years who underwent CABG or PCI were retrospectively collected from 15 European institutions. PCI and CABG had similar 30-day mortality rates (0.8% vs 1.4%, p = 0.27), late survival (at 5 years, 97.8% vs 94.9%, p = 0.082), and freedom from stroke (at 5 years, 98.0% and 98.0%, p = 0.731). PCI was associated with significantly lower freedom from major adverse cardiac and cerebrovascular events (at 5 years, 73.9% vs 85.0%, p <0.0001), repeat revascularization (at 5 years, 77.6% vs 92.5%, p <0.0001), and myocardial infarction (at 5 years, 89.9% vs 96.6%, p <0.0001) compared with CABG. These findings were confirmed in propensity score adjusted and matched analyses. Freedom from major adverse cardiac and cerebrovascular events after PCI was particularly low in diabetics (at 5 years, 58.0% vs 75.9%, p <0.0001) and in patients with multivessel disease (at 5 years, 63.6% vs 85.1%, p <0.0001). PCI in patients with ST elevation myocardial infarction was associated with significantly better 5-year survival (97.5% vs 88.8%, p = 0.001), which was driven by its lower 30-day mortality rate (1.5% vs 6.0%, p = 0.017). In conclusion, patients aged 550 years have an excellent immediate outcome after either PCI or CABG with similar long-term survival when used according to the current clinical practice. PCI was associated with significantly lower freedom from myocardial infarction and repeat revascularization. (C) 2014 Elsevier Inc. All rights reserved.

引用

页码：198 / 205

页数：8

共 12 条

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