tailieunhanh - Drug-Eluting Stents vs. Coronary-Artery Bypass Grafting in Multivessel Coronary Disease

Numerous studies have compared the outcomes of two competing interventions for multivessel coronary artery disease: coronary-artery bypass grafting (CABG) and coronary stenting. However, little information has become available since the introduction of drug-eluting stents. Methods We identified patients with multivessel disease who received drug-eluting stents or underwent CABG in New York State between October 1, 2003, and December 31, 2004, and we compared adverse outcomes (death, death or myocardial infarction, or repeat revascularization) through December 31, 2005, after adjustment for differences in baseline risk factors among the patients | Drug-Eluting Stents vs. Coronary-Artery Bypass Grafting in Multivessel Coronary Disease Drug-Eluting Stents vs. Coronary-Artery Bypass Grafting in Multivessel Coronary Disease Edward L. Hannan . Chuntao Wu . . Gary Walford . Alfred T. Culliford . Jeffrey P Gold . Craig R. Smith . Robert . Higgins . Russell E. Carlson . and Robert H. Jones . abstract background Numerous studies have compared the outcomes of two competing interventions for multivessel coronary artery disease coronary-artery bypass grafting CABG and coronary stenting. However little information has become available since the introduction of drug-eluting stents. methods We identified patients with multivessel disease who received drug-eluting stents or underwent CABG in New York State between October 1 2003 and December 31 2004 and we compared adverse outcomes death death or myocardial infarction or repeat revascularization through December 31 2005 after adjustment for differences in baseline risk factors among the patients. results In comparison with treatment with a drug-eluting stent CABG was associated with lower 18-month rates of death and of death or myocardial infarction both for patients with three-vessel disease and for patients with two-vessel disease. Among patients with three-vessel disease who underwent CABG as compared with those who received a stent the adjusted hazard ratio for death was 95 confidence interval CI to and the adjusted survival rate was versus P the adjusted hazard ratio for death or myocardial infarction was 95 CI to and the adjusted rate of survival free from myocardial infarction was versus P . Among patients with two-vessel disease who underwent CABG as compared with those who received a stent the adjusted hazard ratio for death was 95 CI to and the adjusted survival rate was versus P the adjusted hazard ratio for death or myocardial infarction

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