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. 2020;35(2):121-127.
doi: 10.5222/MMJ.2020.80270. Epub 2020 Jun 30.

Comparing 5-year Outcomes of Aorta-Coronary Bypass Surgery and Percutaneous Coronary Intervention Performed with New-Generation Drug-Eluting Stents in Non-Diabetic Patients with Multivessel Acute Coronary Syndrome Patients and Intermediate Syntax Score

Firdovsi Ibrahimov  1 , Yusuf Yilmaz  2 , Isfandiyar Ismayilov  1 , Kamran Musayev  3 , Ogtay Oktay Musayev  4 , Shahana Alasgarli  4 , Shafa Shahbazova  4 , Mehriban Isgenderova  4 , Tofig Jahangirov  5
Affiliations

Comparing 5-year Outcomes of Aorta-Coronary Bypass Surgery and Percutaneous Coronary Intervention Performed with New-Generation Drug-Eluting Stents in Non-Diabetic Patients with Multivessel Acute Coronary Syndrome Patients and Intermediate Syntax Score

Firdovsi Ibrahimov et al. Medeni Med J. 2020.

Abstract
in English, Turkish

Objective: Our main objective is to determine the difference between patients undergoing CABG and PCI with new-generation drug-eluting stents who were non-diabetic during the course of a multivessel acute coronary syndrome (ACS) and intermediate SYNTAX score.

Methods: Between 2012 and 2014, we retrospectively evaluated 1011 non-diabetic patients with ACS in a single center. The patients were followed up up to 5-years. All- cause mortality, cardiac death, myocardial infarction, stroke, revascularization and stent thrombosis were recorded accordingly.

Results: A total of 516 (51%) patients were included in the PCI group and 495 patients (49%) in the CABG group. Stroke occurrence (PCI group: 0.8%, and CABG group: 2.6%, p=0.022), requirement for recurrent revascularizations (PCI group: 13.6%, and CABG group: 8.1%, p=0.005) and the MACE percentage (PCI group: 20.3%, and CABG group: 14.5%, p=0.015) were statistically significant between two groups. However, there was no statistical significance difference between two groups in terms of primary endpoints including death, MI, and stroke (PCI group: 10.9%, and CABG group: 8.3%, p=0.165) and all-cause mortality PCI group 6.2%, and CABG group: 4.7%, p=0.298).

Conclusion: There was no difference in all-cause mortality and myocardial infarction between the PCI and the CABG groups during 5-year follow-up. The frequency of repeated revascularizations was lower in the CABG group than the PCI group. In contrast, the stroke rates were higher in the CABG group.

Amaç: Araştırmadaki temel amacımız, çok damarlı akut koroner sendromu (ACS) ve ara değer SYNTAX puanı bulunan süreçte diyabetik olmayan CABG ve (yeni nesil ilaç salınımlı stentli) PCI geçiren hastalar arasındaki farkı saptamaktır.

Yöntem: 2012-2014 arasında tek merkezde, ACS’li 1011 diyabetik olmayan hastayı retrospektif olarak değerlendirdik. Hastaların takibi 5 yıla kadar yapılmıştır. Tüm nedenlere bağlı ölüm, kardiyak ölüm, miyokard enfarktüsü, inme, revaskülarizasyon ve stent trombozu buna göre kaydedilmiştir.

Bulgular: 516 (%51) hasta PCI grubuna, 495 hasta (%49) CABG grubuna alınmıştır. İnme oluşumu (PCI grubunda %0,8 ve CABG grubunda %2,6, p=0,022), tekrarlanan revaskülarizasyon gereksinimi (PCI grubunda %13,6 ve CABG grubunda %8,1, p=0,005) ve MACE yüzdeleri (PCI grubunda %20 ,3, CABG grubunda %14,5, p=0,015) iki grup arasında istatistiksel olarak anlamlı derecede farklı bulunmuştur. Öte yandan, ölüm, MI ve inme (PCI grubunda %10,9 ve CABG grubunda %8,3, p=0,165) ve tüm nedenlere bağlı mortalite (PCI grubunda %6,2, CABG grubunda %4,7, p=0,298) dahil olmak üzere birincil sonlanım noktaları arasında iki grup karşılaştırıldığında istatistiksel açıdan anlamlılık fark yoktur.

Sonuç: Beş yıllık takip sırasında tüm nedenlere bağlı mortalite ve miyokart enfarktüsü açısından PCI ile CABG grupları arasında anlamlı fark bulunmamıştır. Tekrarlanan revaskülarizasyon ise CABG grubunda PCI grubundan daha düşüktür. Bunun aksine, inme oranları CABG grubunda daha yüksek çıkmıştır.

Keywords: CABG; PCI; acute coronary syndrome; mortality; non-diabetic; stent.

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Conflict of interest statement

Conflict of interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier Survival Analysis also shows that there is no difference between PCI (in the use of new-generation drug eluting stents) and CABG during 5-year observation.
See this image and copyright information in PMC

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