In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. 19 ( 2016-05-10), p. 1878-1891
Abstract:
Age and sex are important considerations in the choice between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in daily clinical practice. Methods and Results— Of 25 816 patients enrolled in the multicenter Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto; Cohort-1, n=9877; Cohort-2, n=15 939), the present study population consisted of 5651 patients (men, n=3998; women, n=1653) with triple-vessel coronary artery disease who were considered to be pertinent in comparisons of PCI with CABG (PCI, n=3165; CABG, n=2486). Patients were divided into 3 groups according to the tertiles of age: ≤65 years (n=1972), 66 to 73 years (n=1820), and ≥74 years (n=1859). The excess adjusted mortality risk of PCI relative to CABG was significant in patients ≥74 years of age (hazard ratio [HR], 1.40; 95% confidence interval [CI] , 1.10–1.79; P =0.006), whereas the risks were neutral in patients ≤65 years of age (HR, 1.05; 95% CI, 0.73–1.53; P =0.78) and in patients 66 to 73 years of age (HR, 1.03; 95% CI, 0.78–1.36; P =0.85; interaction P =0.003). The excess mortality risk of PCI relative to CABG was significant in men (HR, 1.24; 95% CI, 1.03–1.50; P =0.02) and trended to be significant in women (HR, 1.34; 95% CI, 0.98–1.84; P =0.07) without significant interaction between sex and the mortality risk of PCI relative to CABG (interaction P =0.40). Conclusions— There was a significant association between age and the mortality risk of PCI relative to CABG with excess risk in patients ≥74 years of age and neutral risk in younger patients. There was no significant sex-related difference in the mortality risk of PCI relative to CABG.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/CIRCULATIONAHA.115.020955
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2016
detail.hit.zdb_id:
1466401-X
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