Abstract 15162: Long-Term Comparison of Drug-Eluting Stents and Coronary-Artery Bypass Grafting for Multivessel Coronary Artery Disease : 5-Year Results From the ASAN-Multivessel Registry
Background: Limited information is available on long-term outcomes for patients with multivessel coronary artery disease who underwent drug-eluting stents (DES) or coronary-artery bypass grafting (CABG).
Methods: We evaluated 3,042 patients with multivessel disease who received DES (n=1,547) or underwent CABG (n=1,495) between January 2003 and December 2005 and for whom complete follow-up data were available for median 5.6 years (interquartile range, 4.6–6.3). We compared adverse outcomes (death; a composite outcome of death, myocardial infarction [MI], or stroke; and repeat revascularization).
Results: After adjustment for differences in baseline risk factors, 5-year risk of death (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.73–1.25, P=0.75) and the combined risk of death, MI, or stroke (HR, 0.95; 95% CI, 0.75–1.20, P=0.65) were not significantly different for patients undergoing DES versus CABG. However, the risk of TVR was significantly higher in the DES group than in the CABG group (HR, 2.76; 95% CI, 2.09 to 3.65, P<0.001). Similar results were obtained in comparison of DES with CABG for patients with three-vessel disease (death; HR, 1.19; 95% CI, 0.86–1.65, P=0.30, composite outcome; HR, 1.00; 95% CI, 0.75–1.32, P=0.99, revascularization; HR, 3.60; 95% CI, 2.50–5.19, P<0.001). However, mortality benefit with DES implantation was noted in patients with two-vessel disease (HR, 0.57; 95% CI, 0.36–0.89, P=0.01).
Conclusions: During 5-year long-term follow-up, DES treatment showed similar rates of mortality and of the composite of death, MI, or stroke, but higher rates of revascularization, as compared with CABG, for patients with multivessel disease.
- © 2010 by American Heart Association, Inc.