Comparison of 30-Day and 5-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients Aged 鈮?0聽Years (the Coronary aRtery diseAse in younG adultS Study)

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• 作者：Fausto Biancari ; MD ; PhD^a ; ^{faustobiancari@yahoo.it" class="auth_mail} ; Tomas Gudbjartsson ; MD ; PhD^b ; Jouni Heikkinen ; MD ; PhD^a ; Vesa Anttila ; MD ; PhD^a ; Timo Mä ; kikallio ; MD ; PhD^c ; Anders Jeppsson ; MD ; PhD^d ; Linda Thimour-Bergströ ; m ; RN^d ; Carmelo Mignosa ; MD^e ; Antonino S. Rubino ; MD^e ; Kari Kuttila ; MD ; PhD^f ; Jarmo Gunn ; MD^f ; Jan-Ola Wistbacka ; MD ; PhD^g ; Kari Teittinen ; MD^h ; Kari Korpilahti ; MDⁱ ; Francesco Onorati ; MD^j ; Giuseppe Faggian ; MD^j ; Giulia Vinco ; MD^k ; Corrado Vassanelli ; MD^k ; Flavio Ribichini ; MD^k ; Tatu Juvonen ; MD ; PhD^a ; Tomas A. Axelsson ; MD^b ; Axel F. Sigurdsson ; MD ; PhD^l ; Pasi P. Karjalainen ; MD ; PhD^m ; Ari Mennander ; MD ; PhDⁿ ; Olli Kajander ; MD ; PhDⁿ ; Markku Eskola ; MD ; PhDⁿ ; Erkki Ilveskoski ; MD ; PhDⁿ ; Veronica D'Oria ; MD^o ; Marisa De Feo ; MD ; PhD^o ; Tuomas Kiviniemi ; MD ; PhD^f ; K.E. Juhani Airaksinen ; MD ; PhD^f
• 刊名：The American Journal of Cardiology
• 出版年：15 July 2014
• 年：2014
• 卷：114
• 期：2
• 页码：198-205
• 全文大小：477 K

文摘

Data on the outcome of young patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are scarce. Data on 2,209 consecutive patients aged ≤50 years who underwent CABG or PCI were retrospectively collected from 15 European institutions. PCI and CABG had similar 30-day mortality rates (0.8% vs 1.4%, p = 0.27), late survival (at 5 years, 97.8% vs 94.9%, p = 0.082), and freedom from stroke (at 5 years, 98.0% and 98.0%, p = 0.731). PCI was associated with significantly lower freedom from major adverse cardiac and cerebrovascular events (at 5 years, 73.9% vs 85.0%, p <0.0001), repeat revascularization (at 5 years, 77.6% vs 92.5%, p <0.0001), and myocardial infarction (at 5 years, 89.9% vs 96.6%, p <0.0001) compared with CABG. These findings were confirmed in propensity score–adjusted and matched analyses. Freedom from major adverse cardiac and cerebrovascular events after PCI was particularly low in diabetics (at 5 years, 58.0% vs 75.9%, p <0.0001) and in patients with multivessel disease (at 5 years, 63.6% vs 85.1%, p <0.0001). PCI in patients with ST elevation myocardial infarction was associated with significantly better 5-year survival (97.5% vs 88.8%, p = 0.001), which was driven by its lower 30-day mortality rate (1.5% vs 6.0%, p = 0.017). In conclusion, patients aged ≤50 years have an excellent immediate outcome after either PCI or CABG with similar long-term survival when used according to the current clinical practice. PCI was associated with significantly lower freedom from myocardial infarction and repeat revascularization.