Go to main contents Go to main menus

사용자별 맞춤메뉴

자주찾는 메뉴

추가하기
닫기

Research Articles

contents area

detail content area

Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure
  • Date2021-02-23 17:15
  • Update2021-02-23 17:15
  • CountersignatureDivision of Research Planning
  • Tel043-719-8033

Heart, 2020.106, 50-57, DOI: https://doi.org/10. 1136/heartjnl-2018-313242


Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure

Sang Eun Lee, Hae-Young Lee; Hyun-Jai Cho; Won-Seok Choe; Hokon Kim; Jin Oh Choi; Eun-Seok Jeon; Min-Seok Kim; Kyung-Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok-Min Kang; Dong-Ju Choi; Byung-Su Yoo; Kye Hun Kim; Myeong-Chan Cho; Jae-Joong Kim; Byung-Hee Oh


Abstract

    Objective: Myocardial ischaemia is a leading cause of acute heart failure (AHF). However, optimal revascularisation strategies in AHF are unclear. We aimed to compare two revascularisation strategies, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), in patients with AHF.

    Methods: Among 5625 consecutive patients enrolled prospectively in the Korean Acute Heart Failure registry from March 2011 to February 2014, 717 patients who received CABG or PCI during the index hospitalisation for AHF were included in this analysis. We compared adverse outcomes (death, rehospitalisation for HF aggravation or cardiovascular causes, ischaemic stroke and a composite outcome of death and rehospitalisation for HF aggravation or cardiovascular causes) with the use of propensity score matching.

    Results: For the propensity score-matched cohort with 190 patients, CABG had a lower risk of all-cause mortality than PCI (83 vs 147 deaths per 1000 patient-years; HR 0.57, 95% CI 0.34 to 0.96, p=0.033) during the median follow-up of 4 years. There was also a trend towards lower rates of rehospitalisation due to cardiovascular events or HF aggravation. Subgroup analysis revealed that the adverse outcomes were significantly lower in the CABG group than in PCI group, especially in patients with old age, three-vessel diseases, significant proximal left anterior descending artery disease and those without left main vessel disease or chronic total occlusion.

    Conclusions: Compared with PCI, CABG is associated with significant lower all-cause mortality in patients with AHF. Further studies should evaluate proper revascularisation strategies in AHF.



  • 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
  • This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.


This public work may be used under the terms of the public interest source This public work may be used under the terms of the public interest source
TOP