論文

国際誌
2021年4月15日

Comparison of Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting Among Patients With Three-Vessel Coronary Artery Disease in the New-Generation Drug-Eluting Stents Era (From CREDO-Kyoto PCI/CABG Registry Cohort-3).

The American journal of cardiology
  • Yukiko Matsumura-Nakano
  • ,
  • Hiroki Shiomi
  • ,
  • Takeshi Morimoto
  • ,
  • Kyohei Yamaji
  • ,
  • Natsuhiko Ehara
  • ,
  • Hiroki Sakamoto
  • ,
  • Yasuaki Takeji
  • ,
  • Yusuke Yoshikawa
  • ,
  • Ko Yamamoto
  • ,
  • Kazuaki Imada
  • ,
  • Takeshi Tada
  • ,
  • Ryoji Taniguchi
  • ,
  • Ryusuke Nishikawa
  • ,
  • Tomohisa Tada
  • ,
  • Takashi Uegaito
  • ,
  • Tatsuya Ogawa
  • ,
  • Miho Yamada
  • ,
  • Teruki Takeda
  • ,
  • Hiroshi Eizawa
  • ,
  • Nobushige Tamura
  • ,
  • Keiichi Tambara
  • ,
  • Satoru Suwa
  • ,
  • Manabu Shirotani
  • ,
  • Toshihiro Tamura
  • ,
  • Moriaki Inoko
  • ,
  • Junichiro Nishizawa
  • ,
  • Masahiro Natsuaki
  • ,
  • Hiroshi Sakai
  • ,
  • Takashi Yamamoto
  • ,
  • Naoki Kanemitsu
  • ,
  • Nobuhisa Ohno
  • ,
  • Katsuhisa Ishii
  • ,
  • Akira Marui
  • ,
  • Hiroshi Tsuneyoshi
  • ,
  • Yasuhiko Terai
  • ,
  • Shogo Nakayama
  • ,
  • Kazuhiro Yamazaki
  • ,
  • Mamoru Takahashi
  • ,
  • Takashi Tamura
  • ,
  • Jiro Esaki
  • ,
  • Shinji Miki
  • ,
  • Tomoya Onodera
  • ,
  • Hiroshi Mabuchi
  • ,
  • Yutaka Furukawa
  • ,
  • Masaru Tanaka
  • ,
  • Tatsuhiko Komiya
  • ,
  • Yoshiharu Soga
  • ,
  • Michiya Hanyu
  • ,
  • Kenji Ando
  • ,
  • Kazushige Kadota
  • ,
  • Kenji Minatoya
  • ,
  • Yoshihisa Nakagawa
  • ,
  • Takeshi Kimura

145
開始ページ
25
終了ページ
36
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.amjcard.2020.12.076

There is a scarcity of data comparing long-term clinical outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with three-vessel coronary artery disease (3VD) in the new-generation drug-eluting stents era. CREDO-Kyoto PCI/CABG registry Cohort-3 enrolled 14927 consecutive patients who had undergone first coronary revascularization with PCI or isolated CABG between January 2011 and December 2013. We identified 2525 patients with 3VD (PCI: n = 1747 [69%], and CABG: n = 778 [31%]). The primary outcome measure was all-cause death. Median follow-up duration was 5.7 (interquartile range: 4.4 to 6.6) years. The cumulative 5-year incidence of all-cause death was significantly higher in the PCI group than in the CABG group (19.8% vs 13.2%, log-rank p = 0.001). After adjusting confounders, the excess risk of PCI relative to CABG for all-cause death remained significant (HR, 1.45; 95% CI, 1.14 to 1.86; p = 0.003), which was mainly driven by the excess risk for non-cardiovascular death (HR, 1.88; 95% CI, 1.30 to 2.79; p = 0.001), while there was no excess risk for cardiovascular death between PCI and CABG (HR, 1.19; 95% CI, 0.87 to 1.64; p = 0.29). There was significant excess risk of PCI relative to CABG for myocardial infarction (HR, 1.77; 95% CI, 1.19 to 2.69; p = 0.006), whereas there was no excess risk of PCI relative to CABG for stroke (HR, 1.24; 95% CI, 0.83 to 1.88; p = 0.30). In conclusion, in the present study population reflecting real-world clinical practice in Japan, PCI compared with CABG was associated with significantly higher risk for all-cause death, while there was no excess risk for cardiovascular death between PCI and CABG.

リンク情報
DOI
https://doi.org/10.1016/j.amjcard.2020.12.076
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33454340
ID情報
  • DOI : 10.1016/j.amjcard.2020.12.076
  • PubMed ID : 33454340

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