Hybrid coronary revascularization vs.percutaneous coronary interventions for multivessel coronary artery disease
Edward L.Hannan1
Yi-Feng WU1
Kimberly Cozzens1
Jacqueline Tamis-Holland2
Frederick S.K.Ling3
Alice K.Jacobs4
Ferdinand J.Venditti5
Peter B.Berger6
Gary Walford7
Spencer B.King,Ⅲ8
1.University at Albany,State University of New York,Albany,NY,USA2.Mount Sinai St.Luke's Hospital,New York,NY,USA3.University of Rochester Medical Center,Rochester,NY,USA4.Boston Medical Center,Boston,MA,USA5.Albany Medical Center,Albany,NY,USA6.Unaffiliated7.Johns Hopkins Medical Center8.Emory Health System,Atlanta,GA,USA
摘要：OBJECTIVE Hybrid coronary revascularization(HCR)combines a minimally invasive surgical approach to the left anterior descending(LAD)artery with percutaneous coronary intervention(PCI)for non-LAD diseased coronary arteries.It is associated with shorter hospital lengths of stay and recovery times than conventional coronary artery bypass surgery,but there is little in-formation comparing it to isolated PCI for multivessel disease.Our objective is to compare long-term outcomes of HCR and PCI for patients with multivessel disease.METHODS This cohort study used data from New York's cardiac surgery and PCI registries in 2010-2016 to examine mortal-ity and repeat revascularization rates for patients with multivessel coronary artery disease who underwent HCR and PCI.Cox proportional hazards methods were used to reduce selection bias.Patients were followed for a median of four years.RESULTS There was a total of 335 HCR patients(1.2％)and 25,557 PCI patients(98.8％)after exclusions.There was no differ-ence in 6-year risk adjusted survival between HCR and PCI patients(83.17％vs.81.65％,adjusted hazard ratio(aHR)= 0.90(95％CI:0.67-1.20).However,HCR patients were more likely to be free from repeat revascularization in the LAD artery(91.13％vs.83.59％,aHR = 0.51(95％CI:0.34-0.77)).CONCLUSIONS For patients with multi-vessel coronary artery disease,HCR is rarely performed.There are no differences in mortality rates after four years,but HCR is associated with lower repeat revascularization rates in the LAD artery,presumably due to better longevity in left arterial mammary grafts.
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论文发表日期：2021-03-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 159-167 )