Abstract 12089: Effect of the Completeness of Revascularization in the Survival of Patients with Stable Multivessel Coronary Artery Disease in a 10-Year Follow-Up Of Mass II Trial
Background: The importance of completeness of revascularization remains unclear and contradictory. This current investigation compares the effect of the completeness of revascularization in the 10-year survival of patients with stable multivessel coronary artery disease (CAD), who were randomized to PCI or CABG.
Methods: This is a post-hoc analysis of the Medicine, Angioplasty, or Surgery Study II (MASS II) trial, which is a randomized trial comparing treatment in patients with stable multivessel CAD, and normal systolic ventricular function. We analyzed the patients that underwent surgery (CABG) or stent angioplasty (PCI). The survival free of overall mortality of the patients that were submitted to complete (CR) or incomplete revascularization (IR) was compared.
Results: Of the 408 patients randomized to mechanical revascularization, 390 patients (95.6%) underwent the assigned treatment; complete revascularization was achieved in 224 patients (57.4%), 63.8% of those in the CABG group and 36.2% in the PCI group (P=0,001). IR group had more prior myocardial infarction than CR group (56.2% x 39.2%, P=0.01). During a 10-year follow-up, survival free of overall mortality was significantly different among patients in the groups, (CR = 78.1% x IR =66.9%; P=0.028). There was not any difference in survival free of overall mortality when the analysis was stratified for the therapeutic strategy (CABG = 74.2% x PCI = 72.4%; P=0.720).
Conclusion: Our study suggests that, in a 10-year follow-up, complete revascularization was associated with less mortality when compared to incomplete revascularization. This difference was independent from the revascularization therapeutic strategy.
- © 2011 by American Heart Association, Inc.