Abstract 1812: Five Year Follow-Up of Patients Aged >65 Who Underwent Medical Therapy, Coronary Angioplasty, or Bypass Surgery: MASS II
Introduction: Many patients with coronary artery disease are > 65 years of age. Despite routine use of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI), there is no conclusive evidence that either one is superior to medical therapy (MT) alone for the treatment of multivessel CAD with preserved ventricular function in patients >65.
Methods: The primary end-point was cardiac mortality, myocardial infarction (MI), or refractory angina requiring revascularization in patients > 65. All data were analyzed according to the intention-to-treat principle.
Results: A total of 200 patients were randomly assigned to either CABG (n= 64), PCI (n= 68), or MT (n = 68). The rates of 5-year survival were 84.4% for CABG 82.4% for PCI, and 82.4% for MT. The rates for 5-year survival free of events were 76.6% for CABG, 55.9% for PCI, and 60.3% for MT (p = 0.034).
Conclusion: Coronary artery bypass graft surgery (CABG) was associated with a lower incidence of events compared with PCI and MT in elderly patients in the MASS II study. All 3 therapeutic regimens yielded relatively low rates of cardiac-related death.