Comparison of survival rate and complications of percutaneous coronary intervention, coronary artery bypass graft, and medical treatment in patients with left main and/or three vessel diseases

BACKGROUND: The probable complications of ۳ different cardiovascular diseases treatment options including percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and medical therapy (MT), especially in individuals suffering from left main (LM) and/or three vessel diseases (۳VDs), have received less attention. Thus, the aim of this study was to compare the complications of the aforementioned therapeutic strategies in patients admitted with LM coronary artery disease (CAD)‎ and/or having ۳VDs.METHODS: From March ۲۰۱۸ to March ۲۰۱۹, a total number of ۲۵۱ eligible individuals (۸۷, ۸۶, and ۷۸ subjects treated with PCI, CABG, and MT, respectively) were recruited in this cohort study. After the initiation of treatment, all individuals were followed for ۶ months. Occurrence of any complications including chest pain (CP), re-hospitalization due to cardiac problems, heart failure (HF), death, myocardial infarction (MI), and stroke as well as major adverse cardiac events (MACE) were assessed.RESULTS: Significantly lower percentages of CP, readmission, and HF were observed in the CABG group compared to the PCI and MT groups (۲۴.۴% vs. ۴۷.۱% and ۵۳.۹%, P < ۰.۰۰۱; ۳.۵% vs. ۱۳.۸% and ۵.۱%, P = ۰.۰۲۰; ۱.۲% vs. ۲.۳% and ۹%; P = ۰.۰۴۰, respectively). Further analysis revealed an increased likelihood of hospitalization in the PCI group (OR: ۳.۸۲, ۹۵% CI: ۱.۰۱-۱۴.۴۱, P = ۰.۰۴۰), and a lower risk of CP and HF occurrence in the CABG group subjects compared to the MT group (OR: ۰.۲۸, ۹۵% CI: ۰.۱۳-۰.۶۲, P = ۰.۰۰۲ and OR: ۰.۰۵, ۹۵% CI: ۰.۰۰۴-۰.۷۱, P = ۰.۰۳۰, respectively). This pattern was also observed in the PCI group in terms of HF (OR: ۰.۱۲, ۹۵% CI: ۰.۰۲-۰.۸۳, P = ۰.۰۳۰).CONCLUSION: Patients suffering from LM and/or ۳VDs would most likely benefit from CABG followed by PCI, rather than MT. Further large-scale studies are required to confirm these results.

کلیدواژه ها:

Coronary Artery Bypass Grafting ، Percutaneous Coronary Intervention ، Coronary Vessels ، Coronary Artery Disease