Percutaneous Coronary Intervention VersusMyocardial Revascularization Surgery inMultivessel Coronary Artery Disease: Four-Year Followup
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| Format: | Artículo científico |
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Medical Education Cooperation with Cuba
2022
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| author | Adrián Naranjo-Domínguez |
| author_facet | Adrián Naranjo-Domínguez |
| contents | Percutaneous Coronary Intervention VersusMyocardial Revascularization Surgery inMultivessel Coronary Artery Disease: Four-Year Followup Adrián Naranjo-Domínguez Ronald Aroche-Aportela Myder Hernández-Navas Lázaro I. Aldama-Pérez Ricardo A García-Hernández Alexander Valdés-Martín Medicina Cuba angioplasty Coronary disease coronary artery bypass myocardial revascularization INTRODUCTION In Cuba, 29,939 deaths from ischemic heart disease were recorded in 2020. Myocardial revascularization surgery and percutaneous coronary intervention are well-established methods of treating patients with multivessel coronary artery disease. These methods can reduce overall deaths, but choosing the optimal strategy for treating left main coronary ischemia is a source of debate among specialists.OBJECTIVE Estimate survival and major cardiac and cerebrovascular events in patients treated with percutaneous coronary intervention versus myocardial revascularization surgery and their relationships with pre-existing patients’ clinical and angiographic characteristics.METHODS We conducted a retrospective cohort study in 41 patients; 35 men and 6 women aged 40–85 years who had been diagnosed with multivessel coronary artery disease and treated with percutaneous coronary intervention (n = 17) or myocardial revascularization surgery (n = 24) at the Medical–Surgical Research Center in Havana, Cuba, in 2016. The main variable under consideration was the occurrence of major adverse cardiovascular events over a four-year period following these interventions. We collected clinical and angiographic characteristics, and used the Kaplan–Meier test to calculate survival curves. Survival probabilities were compared using the log-rank test. A value of p <0.05 was considered statistically significant. The Cox proportional hazards model was used to estimate the hazard ratio, with 95% confidence intervals used for both procedures.RESULTS There were a total of 20 major adverse cardiovascular events, 75% (15/20) of which occurred in patients who underwent percutaneous coronary intervention and 5% in patients who had myocardial revascularization surgery. The probability of survival was 70.6% in surgery and 37.5% in interventionism; p = 0.043; hazard ratio 1.58 (95% confidence interval 0.987–2.530), p = 0.047. The need to repeat a revascularization procedure was the only major cardiovascular event that showed significant differences between methods (log-rank p = 0.015), and was more frequent in percutaneous intervention.CONCLUSIONS Myocardial revascularization surgery offers a better chance of survival than percutaneous coronary intervention. Major adverse cardiovascular events are more frequent in patients with coronary interventionism, due to the need to repeat revascularization. 2022 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437569929009 https://www.redalyc.org/journal/4375/437569929009/ https://www.redalyc.org/journal/4375/437569929009/html/ https://www.redalyc.org/journal/4375/437569929009/437569929009.epub https://www.redalyc.org/journal/4375/437569929009/movil https://doi.org/10.37757/MR2022.V24.N1.10 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.24 |
| format | Artículo científico |
| id | redalyc_437569929009 |
| institution | Redalyc |
| language | en |
| publishDate | 2022 |
| publisher | Medical Education Cooperation with Cuba |
| spellingShingle | Percutaneous Coronary Intervention VersusMyocardial Revascularization Surgery inMultivessel Coronary Artery Disease: Four-Year Followup Adrián Naranjo-Domínguez Medicina Cuba angioplasty Coronary disease coronary artery bypass myocardial revascularization Percutaneous Coronary Intervention VersusMyocardial Revascularization Surgery inMultivessel Coronary Artery Disease: Four-Year Followup Adrián Naranjo-Domínguez Ronald Aroche-Aportela Myder Hernández-Navas Lázaro I. Aldama-Pérez Ricardo A García-Hernández Alexander Valdés-Martín Medicina Cuba angioplasty Coronary disease coronary artery bypass myocardial revascularization INTRODUCTION In Cuba, 29,939 deaths from ischemic heart disease were recorded in 2020. Myocardial revascularization surgery and percutaneous coronary intervention are well-established methods of treating patients with multivessel coronary artery disease. These methods can reduce overall deaths, but choosing the optimal strategy for treating left main coronary ischemia is a source of debate among specialists.OBJECTIVE Estimate survival and major cardiac and cerebrovascular events in patients treated with percutaneous coronary intervention versus myocardial revascularization surgery and their relationships with pre-existing patients’ clinical and angiographic characteristics.METHODS We conducted a retrospective cohort study in 41 patients; 35 men and 6 women aged 40–85 years who had been diagnosed with multivessel coronary artery disease and treated with percutaneous coronary intervention (n = 17) or myocardial revascularization surgery (n = 24) at the Medical–Surgical Research Center in Havana, Cuba, in 2016. The main variable under consideration was the occurrence of major adverse cardiovascular events over a four-year period following these interventions. We collected clinical and angiographic characteristics, and used the Kaplan–Meier test to calculate survival curves. Survival probabilities were compared using the log-rank test. A value of p <0.05 was considered statistically significant. The Cox proportional hazards model was used to estimate the hazard ratio, with 95% confidence intervals used for both procedures.RESULTS There were a total of 20 major adverse cardiovascular events, 75% (15/20) of which occurred in patients who underwent percutaneous coronary intervention and 5% in patients who had myocardial revascularization surgery. The probability of survival was 70.6% in surgery and 37.5% in interventionism; p = 0.043; hazard ratio 1.58 (95% confidence interval 0.987–2.530), p = 0.047. The need to repeat a revascularization procedure was the only major cardiovascular event that showed significant differences between methods (log-rank p = 0.015), and was more frequent in percutaneous intervention.CONCLUSIONS Myocardial revascularization surgery offers a better chance of survival than percutaneous coronary intervention. Major adverse cardiovascular events are more frequent in patients with coronary interventionism, due to the need to repeat revascularization. 2022 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437569929009 https://www.redalyc.org/journal/4375/437569929009/ https://www.redalyc.org/journal/4375/437569929009/html/ https://www.redalyc.org/journal/4375/437569929009/437569929009.epub https://www.redalyc.org/journal/4375/437569929009/movil https://doi.org/10.37757/MR2022.V24.N1.10 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.24 |
| title | Percutaneous Coronary Intervention VersusMyocardial Revascularization Surgery inMultivessel Coronary Artery Disease: Four-Year Followup |
| topic | Medicina Cuba angioplasty Coronary disease coronary artery bypass myocardial revascularization |
| url | https://www.redalyc.org/articulo.oa?id=437569929009 https://www.redalyc.org/journal/4375/437569929009/ https://www.redalyc.org/journal/4375/437569929009/html/ https://www.redalyc.org/journal/4375/437569929009/437569929009.epub https://www.redalyc.org/journal/4375/437569929009/movil https://doi.org/10.37757/MR2022.V24.N1.10 |