Long-term mortality in patients with ischaemic heart failure revascularized with coronary artery bypass grafting or percutaneous coronary intervention: Insights from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

Sebastian Völz, Björn Redfors, Oskar Angerås, Dan Ioanes, Jacob Odenstedt, Sasha Koul, Inger Valeljung, Christian Dworeck, Robin Hofmann, Emma Hansson, Dimitrios Venetsanos, Anders Ulvenstam, Tomas Jernberg, Truls Råmunddal, Pétur Pétursson, Ole Fröbert, David Erlinge, Anders Jeppsson, Elmir Omerovic*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

45 Citationer (Scopus)

Abstract

Aims: To compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of patients with heart failure due to ischaemic heart disease. Methods and results: We analysed all-cause mortality following CABG or PCI in patients with heart failure with reduced ejection fraction and multivessel disease (coronary artery stenosis >50% in ≥2 vessels or left main) who underwent coronary angiography between 2000 and 2018 in Sweden. We 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 >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 [odds ratio (OR) 0.62; 95% confidence interval (CI) 0.41-0.96; P = 0.031]. The risk of death increased linearly with quintiles of hospitals in which PCI was the preferred method for revascularization (OR 1.27, 95% CI 1.17-1.38, Ptrend < 0.001). Conclusion: In patients with ischaemic heart failure, long-term survival was greater after CABG than after PCI.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
Vol/bind42
Nummer27
Sider (fra-til)2657-2664
Antal sider8
ISSN0195-668X
DOI
StatusUdgivet - 14 jul. 2021
Udgivet eksterntJa

Fingeraftryk

Dyk ned i forskningsemnerne om 'Long-term mortality in patients with ischaemic heart failure revascularized with coronary artery bypass grafting or percutaneous coronary intervention: Insights from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)'. Sammen danner de et unikt fingeraftryk.

Citationsformater