Coronary disease & ACSCohort study
Percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease: the SWEDEHEART registry
- Registry-based cohort study
- nationwide registry (SWEDEHEART)
- multilevel logistic regression
- double-robust adjustment with instrumental variable method
Authors' 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
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:10.1093/eurheartj/ehae700
Summarised from the published abstract; every number is checked against it