Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction
Objectives: We compared the outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) for revascularization in patients with reduced ejection fraction (EF) and severe coronary artery disease (CAD). Methods: Between February 2006 and February 2020, a to...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/9/2233 |
| _version_ | 1797489375316017152 |
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| author | Yu-Wen Chen Wei-Chieh Lee Hsiu-Yu Fang Cheuk-Kwan Sun Jiunn-Jye Sheu |
| author_facet | Yu-Wen Chen Wei-Chieh Lee Hsiu-Yu Fang Cheuk-Kwan Sun Jiunn-Jye Sheu |
| author_sort | Yu-Wen Chen |
| collection | DOAJ |
| description | Objectives: We compared the outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) for revascularization in patients with reduced ejection fraction (EF) and severe coronary artery disease (CAD). Methods: Between February 2006 and February 2020, a total of 797 patients received coronary angiograms due to left ventricular EF ≤ 40% at our hospital. After excluding diagnoses of dilated cardiomyopathy, valvular heart disease, prior CABG, acute ST-segment myocardial infarction, and CAD with low Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score (≤22), 181 patients with severe coronary artery disease (CAD) with SYNTAX score >22 underwent CABG or PCI for revascularization. Vascular characteristics as well as echocardiographic data were compared between CABG (<i>n</i> = 58) and PCI (<i>n</i> = 123) groups. Results: A younger age (62 ± 9.0 vs. 66 ± 12.1; <i>p</i> = 0.016), higher new EuroSCORE II (8.6 ± 7.3 vs. 3.2 ± 2.0; <i>p</i> < 0.001), and higher SYNTAX score (40.5 ± 9.8 vs. 35.4 ± 8.3; <i>p</i> < 0.001) were noted in the CABG group compared to those in the PCI group. The CABG group had a significantly higher cardiovascular mortality rate at 1-year (19.6% vs. 5.0%, <i>p</i> = 0.005) and 3-year (25.0% vs. 11.4%, <i>p</i> = 0.027) follow-ups but a lower incidence of heart failure (HF) hospitalization at 1-year (11.1% vs. 28.2%, <i>p</i> = 0.023) and 3-year (3.6% vs. 42.5%, <i>p</i> = 0.001) follow-ups compared to those of the PCI group. Conclusions: Compared with PCI, revascularization with CABG was related to a lower incidence of HF hospitalization but a worse survival outcome in patients with severe CAD and reduced EF. CABG-associated reduction in HF hospitalization was more notable when SYNTAX score ≥33. |
| first_indexed | 2024-03-10T00:15:38Z |
| format | Article |
| id | doaj.art-111ee41f9bb7483083e8b52d5886c578 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T00:15:38Z |
| publishDate | 2022-09-01 |
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| series | Diagnostics |
| spelling | doaj.art-111ee41f9bb7483083e8b52d5886c5782023-11-23T15:50:54ZengMDPI AGDiagnostics2075-44182022-09-01129223310.3390/diagnostics12092233Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection FractionYu-Wen Chen0Wei-Chieh Lee1Hsiu-Yu Fang2Cheuk-Kwan Sun3Jiunn-Jye Sheu4Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, TaiwanDivision of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanDepartment of Emergency Medicine, E-Da Hospital, Kaohsiung 83301, TaiwanDivision of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanObjectives: We compared the outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) for revascularization in patients with reduced ejection fraction (EF) and severe coronary artery disease (CAD). Methods: Between February 2006 and February 2020, a total of 797 patients received coronary angiograms due to left ventricular EF ≤ 40% at our hospital. After excluding diagnoses of dilated cardiomyopathy, valvular heart disease, prior CABG, acute ST-segment myocardial infarction, and CAD with low Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score (≤22), 181 patients with severe coronary artery disease (CAD) with SYNTAX score >22 underwent CABG or PCI for revascularization. Vascular characteristics as well as echocardiographic data were compared between CABG (<i>n</i> = 58) and PCI (<i>n</i> = 123) groups. Results: A younger age (62 ± 9.0 vs. 66 ± 12.1; <i>p</i> = 0.016), higher new EuroSCORE II (8.6 ± 7.3 vs. 3.2 ± 2.0; <i>p</i> < 0.001), and higher SYNTAX score (40.5 ± 9.8 vs. 35.4 ± 8.3; <i>p</i> < 0.001) were noted in the CABG group compared to those in the PCI group. The CABG group had a significantly higher cardiovascular mortality rate at 1-year (19.6% vs. 5.0%, <i>p</i> = 0.005) and 3-year (25.0% vs. 11.4%, <i>p</i> = 0.027) follow-ups but a lower incidence of heart failure (HF) hospitalization at 1-year (11.1% vs. 28.2%, <i>p</i> = 0.023) and 3-year (3.6% vs. 42.5%, <i>p</i> = 0.001) follow-ups compared to those of the PCI group. Conclusions: Compared with PCI, revascularization with CABG was related to a lower incidence of HF hospitalization but a worse survival outcome in patients with severe CAD and reduced EF. CABG-associated reduction in HF hospitalization was more notable when SYNTAX score ≥33.https://www.mdpi.com/2075-4418/12/9/2233severe coronary artery diseasereduced ejection fractioncoronary artery bypass graft surgerypercutaneous coronary interventionheart failure hospitalization |
| spellingShingle | Yu-Wen Chen Wei-Chieh Lee Hsiu-Yu Fang Cheuk-Kwan Sun Jiunn-Jye Sheu Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction Diagnostics severe coronary artery disease reduced ejection fraction coronary artery bypass graft surgery percutaneous coronary intervention heart failure hospitalization |
| title | Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction |
| title_full | Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction |
| title_fullStr | Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction |
| title_full_unstemmed | Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction |
| title_short | Coronary Artery Bypass Graft Surgery Brings Better Benefits to Heart Failure Hospitalization for Patients with Severe Coronary Artery Disease and Reduced Ejection Fraction |
| title_sort | coronary artery bypass graft surgery brings better benefits to heart failure hospitalization for patients with severe coronary artery disease and reduced ejection fraction |
| topic | severe coronary artery disease reduced ejection fraction coronary artery bypass graft surgery percutaneous coronary intervention heart failure hospitalization |
| url | https://www.mdpi.com/2075-4418/12/9/2233 |
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