Author/Authors :
Biancari، نويسنده , , Fausto and Gudbjartsson، نويسنده , , Tomas and Heikkinen، نويسنده , , Jouni and Anttila، نويسنده , , Vesa and Mنkikallio، نويسنده , , Timo and Jeppsson، نويسنده , , Anders and Thimour-Bergstrِm، نويسنده , , Linda and Mignosa، نويسنده , , Carmelo and Rubino، نويسنده , , Antonino S. and Kuttila، نويسنده , , Kari and Gunn، نويسنده , , Jarmo and Wistbacka، نويسنده , , Jan-Ola and Teittinen، نويسنده , , Kari and Korpilahti، نويسنده , , Kari and Onorati، نويسنده , , Francesco and Faggian، نويسنده , , Giuseppe and Vinco، نويسنده , , Giulia and Vassanelli، نويسنده , , Corrado and Ribichini، نويسنده , , Flavio and Juvonen، نويسنده , , Tatu and Axelsson، نويسنده , , Tomas A. and Sigurdsson، نويسنده , , Axel F. and Karjalainen، نويسنده , , Pasi P. and Mennander، نويسنده , , Ari and Kajander، نويسنده , , Olli and Eskola، نويسنده , , Markku and Ilveskoski، نويسنده , , Erkki and DʹOria، نويسنده , , Veronica and De Feo، نويسنده , , Marisa and Kiviniemi، نويسنده , , Tuomas and Airaksinen، نويسنده , , K.E. Juhani، نويسنده ,
Abstract :
Data on the outcome of young patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are scarce. Data on 2,209 consecutive patients aged ≤50 years who underwent CABG or PCI were retrospectively collected from 15 European institutions. PCI and CABG had similar 30-day mortality rates (0.8% vs 1.4%, p = 0.27), late survival (at 5 years, 97.8% vs 94.9%, p = 0.082), and freedom from stroke (at 5 years, 98.0% and 98.0%, p = 0.731). PCI was associated with significantly lower freedom from major adverse cardiac and cerebrovascular events (at 5 years, 73.9% vs 85.0%, p <0.0001), repeat revascularization (at 5 years, 77.6% vs 92.5%, p <0.0001), and myocardial infarction (at 5 years, 89.9% vs 96.6%, p <0.0001) compared with CABG. These findings were confirmed in propensity score–adjusted and matched analyses. Freedom from major adverse cardiac and cerebrovascular events after PCI was particularly low in diabetics (at 5 years, 58.0% vs 75.9%, p <0.0001) and in patients with multivessel disease (at 5 years, 63.6% vs 85.1%, p <0.0001). PCI in patients with ST elevation myocardial infarction was associated with significantly better 5-year survival (97.5% vs 88.8%, p = 0.001), which was driven by its lower 30-day mortality rate (1.5% vs 6.0%, p = 0.017). In conclusion, patients aged ≤50 years have an excellent immediate outcome after either PCI or CABG with similar long-term survival when used according to the current clinical practice. PCI was associated with significantly lower freedom from myocardial infarction and repeat revascularization.
