Outcomes Superior With CABG Versus Multivessel PCI

THURSDAY, Jan. 26, 2023 (HealthDay News) -- Coronary artery bypass grafting (CABG) outcomes are better than multivessel percutaneous coronary intervention (PCI) outcomes for patients with acute coronary syndrome, according to a study presented at the annual meeting of The Society of Thoracic Surgeons, held from Jan. 21 to 23 in San Diego.

J. Hunter Mehaffey, M.D., from West Virginia University in Morgantown, and colleagues conducted a comparative effectiveness analysis comparing CABG to multivessel PCI to reevaluate contemporary outcomes among Medicare beneficiaries. All 104,127 beneficiaries with acute coronary syndrome undergoing isolated CABG or multivessel PCI (51,389 and 52,738, respectively) between 2018 and 2020 were included.

The researchers found that patients undergoing CABG were younger than those undergoing PCI (72.9 versus 75.2 years), and they had a higher Elixhauser Comorbidity Index (5.0 versus 4.2) and more diabetes (48.5 versus 42.2 percent). Costs were higher for CABG versus PCI ($57,189 versus $36,342), and length of stay was longer (11.9 versus 5.8 days). CABG was associated with lower hospital mortality, fewer hospital readmissions at three years, less repeat PCI (odds ratios, 0.70, 0.77, and 0.34, respectively), and improved three-year survival (hazard ratio, 0.47) compared with PCI following inverse probability of treatment-weighting propensity score adjustment.

"Regardless of your specialty, these data demonstrate the importance of assessing longitudinal outcomes to help ensure we're making optimal treatment recommendations for our patients," Mehaffey said in a statement.

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