Further Treatment 10 Times More Likely After Coronary Angioplasty Than After Bypass

Main Category: Cardiovascular / Cardiology
Also Included In: Heart Disease
Article Date: 10 Nov 2008 - 2:00 PDT

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Heart patients who have coronary angioplasty are 10 times more likely to require further treatment as those who have a bypass graft, indicates research published ahead of print in the journal Heart.

Coronary angioplasty, known as percutaneous coronary intervention or PCI is a less invasive technique than coronary artery bypass grafting (CABG).

Both procedures are used to treat narrowed or blocked coronary arteries and restore normal blood flow to and from the heart (revascularisation).

The researchers base their findings on more than 6000 heart patients in one representative UK county (Leicestershire; population 946,000) between 1995/6 and 2003/4.

Some 2500 patients underwent CABG, while the remainder underwent PCI. They were monitored after their procedures to see how they fared.

Patients undergoing PCI tended to be younger than CABG patients, who tended to have higher rates of other illnesses, such as heart failure, diabetes, liver disease, and cancer.

The total number of procedures nearly doubled over the decade under study. And despite the increasing complexity of cases, the outcomes for patients undergoing both techniques improved considerably.

Around one in seven patients (just under 13%) died, with 16% of these deaths occurring within the first month after surgery and almost half within the first two years.

But deaths from all causes and from cardiovascular disease were less than 5% in the first two years, with both techniques.

After taking account of the older age and presence of other serious illness prior to treatment, survival rates were similar for both procedures.

But the need for repeat intervention was 10 times as high among those patients undergoing PCI as it was for those undergoing CABG.

"Improving long-term outcomes following coronary artery bypass graft or percutaneous coronary revascularisation: results from a large, population based cohort with first intervention 1995 - 2004."
Online First Heart 2008; doi: 10.1136/hrt.2007.127928]
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