Abstract 2272: Three Year Survival of Drug-Eluting Stents versus Coronary Artery Surgery in Multivessel Coronary Disease
Background. Several studies have compared survival following bare metal stenting (BMS) to coronary artery bypass grafting (CABG). Less is known about how survival following drug eluting stenting (DES), which compared to BMS has a lower risk of repeat revascularization and better survival, compare to CABG.
Methods. From our Northern New England percutaneous intervention (PCI) and CABG registries we identified nonemergent multivessel disease patients who received a DES (n=2520) or underwent CABG (n=2626) in 2004 –2006 and compared 3-year survival through 2007. We adjusted for differences in baseline patient characteristics using Cox proportional-hazards models and propensity matching.
Results. CABG patients had more diabetes, peripheral vascular disease, 3 vessel disease, and more complete revascularization. There was an increased early risk of death through 45 days that was higher for CABG than DES (Figure⇓). Following this early risk, the survival curves were linear, with a higher annual mortality rate for DES (4.1%/year) than for CABG (2.2%/year). The adjusted survival at 3 years for CABG (90.9%) was better that for DES (87.6%, p<0.01). This finding was robust for all patient subgroups and after propensity matching.
Conclusion. For patients with multivessel disease, survival at 3 years is better following CABG than DES, though the initial risk is higher with CABG.