Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases
BACKGROUND: The probable complications of 3 different cardiovascular diseases treatment options including percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and medical therapy (MT), especially in individuals suffering from left main (LM) and/or three vessel diseases (3VD...
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| Format: | Article |
| Language: | English |
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Vesnu Publications
2020-05-01
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| Series: | ARYA Atherosclerosis |
| Subjects: | |
| Online Access: | https://arya.mui.ac.ir/article_10726_d8871c66efac3069a868894c30a78cef.pdf |
| _version_ | 1811154619390230528 |
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| author | Alireza Khosravi Mehrbod Vakhshoori Vahid Sharif Farshad Roghani-Dehkordi Jamshid Najafian Asieh Mansouri |
| author_facet | Alireza Khosravi Mehrbod Vakhshoori Vahid Sharif Farshad Roghani-Dehkordi Jamshid Najafian Asieh Mansouri |
| author_sort | Alireza Khosravi |
| collection | DOAJ |
| description | BACKGROUND: The probable complications of 3 different cardiovascular diseases treatment options including percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and medical therapy (MT), especially in individuals suffering from left main (LM) and/or three vessel diseases (3VDs), have received less attention. Thus, the aim of this study was to compare the complications of the aforementioned therapeutic strategies in patients admitted with LM coronary artery disease (CAD) and/or having 3VDs.METHODS: From March 2018 to March 2019, a total number of 251 eligible individuals (87, 86, and 78 subjects treated with PCI, CABG, and MT, respectively) were recruited in this cohort study. After the initiation of treatment, all individuals were followed for 6 months. Occurrence of any complications including chest pain (CP), re-hospitalization due to cardiac problems, heart failure (HF), death, myocardial infarction (MI), and stroke as well as major adverse cardiac events (MACE) were assessed.RESULTS: Significantly lower percentages of CP, readmission, and HF were observed in the CABG group compared to the PCI and MT groups (24.4% vs. 47.1% and 53.9%, P < 0.001; 3.5% vs. 13.8% and 5.1%, P = 0.020; 1.2% vs. 2.3% and 9%; P = 0.040, respectively). Further analysis revealed an increased likelihood of hospitalization in the PCI group (OR: 3.82, 95% CI: 1.01-14.41, P = 0.040), and a lower risk of CP and HF occurrence in the CABG group subjects compared to the MT group (OR: 0.28, 95% CI: 0.13-0.62, P = 0.002 and OR: 0.05, 95% CI: 0.004-0.71, P = 0.030, respectively). This pattern was also observed in the PCI group in terms of HF (OR: 0.12, 95% CI: 0.02-0.83, P = 0.030).CONCLUSION: Patients suffering from LM and/or 3VDs would most likely benefit from CABG followed by PCI, rather than MT. Further large-scale studies are required to confirm these results. |
| first_indexed | 2024-04-10T04:18:50Z |
| format | Article |
| id | doaj.art-e455d69dcda74955b5d2e4e6c384cb84 |
| institution | Directory Open Access Journal |
| issn | 1735-3955 2251-6638 |
| language | English |
| last_indexed | 2024-04-10T04:18:50Z |
| publishDate | 2020-05-01 |
| publisher | Vesnu Publications |
| record_format | Article |
| series | ARYA Atherosclerosis |
| spelling | doaj.art-e455d69dcda74955b5d2e4e6c384cb842023-03-11T12:58:22ZengVesnu PublicationsARYA Atherosclerosis1735-39552251-66382020-05-01162859310.22122/arya.v16i2.201910726Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseasesAlireza Khosravi0Mehrbod Vakhshoori1Vahid Sharif2Farshad Roghani-Dehkordi3Jamshid Najafian4Asieh Mansouri5Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranHypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranProfessor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranAssistant Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranBACKGROUND: The probable complications of 3 different cardiovascular diseases treatment options including percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and medical therapy (MT), especially in individuals suffering from left main (LM) and/or three vessel diseases (3VDs), have received less attention. Thus, the aim of this study was to compare the complications of the aforementioned therapeutic strategies in patients admitted with LM coronary artery disease (CAD) and/or having 3VDs.METHODS: From March 2018 to March 2019, a total number of 251 eligible individuals (87, 86, and 78 subjects treated with PCI, CABG, and MT, respectively) were recruited in this cohort study. After the initiation of treatment, all individuals were followed for 6 months. Occurrence of any complications including chest pain (CP), re-hospitalization due to cardiac problems, heart failure (HF), death, myocardial infarction (MI), and stroke as well as major adverse cardiac events (MACE) were assessed.RESULTS: Significantly lower percentages of CP, readmission, and HF were observed in the CABG group compared to the PCI and MT groups (24.4% vs. 47.1% and 53.9%, P < 0.001; 3.5% vs. 13.8% and 5.1%, P = 0.020; 1.2% vs. 2.3% and 9%; P = 0.040, respectively). Further analysis revealed an increased likelihood of hospitalization in the PCI group (OR: 3.82, 95% CI: 1.01-14.41, P = 0.040), and a lower risk of CP and HF occurrence in the CABG group subjects compared to the MT group (OR: 0.28, 95% CI: 0.13-0.62, P = 0.002 and OR: 0.05, 95% CI: 0.004-0.71, P = 0.030, respectively). This pattern was also observed in the PCI group in terms of HF (OR: 0.12, 95% CI: 0.02-0.83, P = 0.030).CONCLUSION: Patients suffering from LM and/or 3VDs would most likely benefit from CABG followed by PCI, rather than MT. Further large-scale studies are required to confirm these results.https://arya.mui.ac.ir/article_10726_d8871c66efac3069a868894c30a78cef.pdfcoronary artery bypass graftingpercutaneous coronary interventioncoronary vesselscoronary artery disease |
| spellingShingle | Alireza Khosravi Mehrbod Vakhshoori Vahid Sharif Farshad Roghani-Dehkordi Jamshid Najafian Asieh Mansouri Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases ARYA Atherosclerosis coronary artery bypass grafting percutaneous coronary intervention coronary vessels coronary artery disease |
| title | Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases |
| title_full | Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases |
| title_fullStr | Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases |
| title_full_unstemmed | Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases |
| title_short | Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases |
| title_sort | comparison of survival rate and complications of percutaneous coronary intervention coronary artery bypass graft and medical treatment in patients with left main and or three vessel diseases |
| topic | coronary artery bypass grafting percutaneous coronary intervention coronary vessels coronary artery disease |
| url | https://arya.mui.ac.ir/article_10726_d8871c66efac3069a868894c30a78cef.pdf |
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