Abstract 1850: Clinical Characteristics And Early Mortality Of Patients Undergoing Coronary Artery Bypass Grafting Compared To Percutaneous Coronary Intervention - Insights From Two Large Multi-centre Australian Registries.
Background: The clinical characteristics, risk profile, and mortality of patients undergoing coronary artery bypass graft (CABG) compared to percutaneous coronary intervention (PCI) are thought to differ but there is limited data.
Methods: We compared baseline clinical characteristics and early mortality (in-hospital and 30 day) of 4417 consecutive patients undergoing PCI and 3841 isolated CABG from 1st April 2004 to 30th June 2006 enrolled in the MIG and ASCTS registries respectively. Predictors of 30-day mortality were determined by multivariate logistic regression.
Results: In-hospital / 30 day mortality was 1.4% / 1.8% in the PCI registry, and 1.8% / 1.7% in the CABG registry. Independent predictors (odds ratio, 95% confidence interval) of 30-day mortality after PCI were diabetes (2.7, 1.4–5.1), female gender (3.0, 1.6–5.5), renal failure (3.2, 1.2–8.0), MI<24 hrs (4.0, 2.2–7.6), left main intervention (5.4, 1.0–27.7), CHF (6.0, 2.6–14.0) and shock (11.7, 5.4–25.2) and after CABG were to NYHA class 4 symptoms (2.1, 1.4–3.1), previous CABG (2.1, 1.5–3.3), PVD (2.2, 1.5–3.3), left ventricular ejection fraction <30% (3.5, 2.0–6.1), shock (3.9, 2.1–7.2) and age>80 yrs (5.1, 2.4–10.6).
Conclusion: PCI is the dominant revascularization strategy for acute MI while CABG is preferred in patients with multi-vessel coronary and associated vascular disease. Predictors of mortality after PCI differ to those of CABG.