Coronary disease & ACSCohort study
Coronary artery bypass grafting vs. percutaneous coronary intervention in severe ischaemic cardiomyopathy: long-term survival
- Retrospective cohort study
- multicentre
- registry-based
- propensity-score inverse probability of treatment weighting (IPTW)-adjusted
Authors' conclusion
In this multi-centre IPTW analysis, patients with severe ischaemic cardiomyopathy undergoing revascularization by CABG rather than PCI showed improved long-term survival.
Study context
- Population
- Patients with severe ischaemic cardiomyopathy (left ventricular ejection fraction (LVEF) <35%) undergoing revascularization, Australian and New Zealand registries, 2005–2018; STEMI and cardiogenic shock excluded
- Participants
- 2,042 patients
- Exposure
- Coronary artery bypass grafting (CABG) vs percutaneous coronary intervention (PCI)
- CABGn = 1,451
- PCIn = 591reference
- Outcome
- Long-term National Death Index-linked mortality
- Follow-up
- Up to 10 years following revascularization
Main finding
Long-term mortality · median follow-up 4.0 (IQR 2.2-6.8) years
Adjusted hazard ratio
0.59
95% CI 0.45–0.79
P = 0.001
CABG vs PCI
adjusted HR 0.59 (95% CI 0.45–0.79); P = 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| In-hospital mortality | 1.42 (0.41–4.96) | P = 0.58 | |
| 0.20.5125Adjusted odds ratio (log scale) |
| Outcome | exponentiated coefficient (95% CI) | P value |
|---|---|---|
| Length of hospital stay · increased with CABG | 3.58 (3.00–4.28) | P < 0.001 |
Safety
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Peri-procedural stroke · increased with CABG | 19.6 (4.21–91.6) | P < 0.001 | |
| 0.050.21520Adjusted odds ratio (log scale) |
Original publication
Coronary artery bypass grafting vs. percutaneous coronary intervention in severe ischaemic cardiomyopathy: long-term survival. Eur Heart J. Published 29 October 2024. doi:10.1093/eurheartj/ehae672
Summarised from the published abstract; every number is checked against it