Document Type : Original Article
Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
Department of Emergency Medicine, School of Paramedics, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
Department of Radiology, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Clinical Research Development Center of Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
Background: Our study aimed to compare the 1-year therapeutic outcome between coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in patients with multivessel coronary artery disease (CAD).
Methods: This retrospective cohort study was conducted on 150 patients with multivessel CAD who underwent CABG or PCI in Imam Ali Cardiovascular Center, Kermanshah, Iran, between March 2017 and March 2019. Data were collected using a checklist developed based on the study objectives. Differences between subgroups were assessed by using the independent t test and the χ2 test (or the Fisher exact test). A multivariate binary logistic regression model was used to determine factors associated with referral to CABG or PCI.
Results: The mean age was 63.48 (SD=9.73) years in the PCI group and 60.54 (SD=10.85) years in the CABG group (P=0.741). The CABG group was more likely to have left main disease (16.6% vs 0%; P<0.001). The PCI group was more likely to take an antiplatelet (viz, clopidogrel) and nitrates, whereas the CABG group was more likely to take antihypertensives (angiotensin receptor blockers) and anticoagulants (viz, rivaroxaban and warfarin) (P<0.05). The CABG had significantly higher rates of major bleeding (P=0.003) and arrhythmia (P=0.045) than the PCI group. There was a significant difference in the mortality between the 2 treatment groups (9.3% of the CABG group vs 1.3% of the PCI group; P=0.029). Left main disease was associated with an increased odds of referral to CABG (OR=0.02; P=0.015).
Conclusions: PCI was associated with a lower adverse clinical outcome than CABG in patients with multivessel CAD. (Iranian Heart Journal 2022; 23(1): 25-33)