Percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease: the SWEDEHEART registry
Main finding · All-cause mortalityResult — go to the resultAdjusted odds ratio 1.67 95% CI 1.54–1.81Authors' conclusion
Coronary artery bypass grafting is associated with lower risks of mortality, MI, repeat revascularization, and heart failure in patients with NSTEMI, particularly in high-risk subgroups. However, its survival benefit lessens with shorter life expectancy.
Study context
- Population
- Revascularized patients with NSTEMI and multivessel disease, Sweden, January 2005 to June 2022
- Participants
- 57,097 patients
- Exposure
- Percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG)
- PCIn = 42,190
- CABGn = 14,907reference
- Outcome
- All-cause mortality (in-hospital and long-term)
- Follow-up
- Median 7.1 years
Methodological detailsnationwide registry (SWEDEHEART), multilevel logistic regression, double-robust adjustment with instrumental variable method
- Nationwide registry (SWEDEHEART)
- Multilevel logistic regression
- Double-robust adjustment with instrumental variable method
Main finding
All-cause mortality
Adjusted odds ratio
1.67
95% CI 1.54–1.81
PCI vs CABG
aOR 1.67 (95% CI 1.54–1.81)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | |
|---|---|---|
| MI · median follow-up 7.1 years | 1.51 (1.41–1.62) | |
| Repeat revascularization · median follow-up 7.1 years | 3.01 (2.57–3.51) | |
| HF · median follow-up 7.1 years | 1.15 (1.07–1.25) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Stroke · median follow-up 7.1 years
- No significant difference in stroke
Survival by subgroup and time horizon · within 15 years
- CABG provided longer survival within 15 years, especially in patients under 70 years, with left main disease or LV dysfunction; benefit diminished over shorter time horizons
Original publication
Percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease: the SWEDEHEART registry. Eur Heart J. Published 27 November 2024. doi:10.
Summarised from the published abstract; every number is checked against it