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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Grau-sepulveda, Maria V. Grover, Frederick L. Garratt, Kirk N. O'brien, Sean M. Ritzenthaler, Laura L. Messenger, John C. Peterson, Eric D. Zhang, Zugui Mckay, Charles Weiss, Jocelyn M. Klein, Lloyd W. Weintraub, William S. Popma, Jeffrey J. Moussa, Issam D. Dangas, George D. Shahian, David M. Mayer, John E. Kolm, Paul Edwards, Fred H. Shewan, Cynthia M. Shaw, Richard E. |
| Spatial Coverage | United States |
| Description | Author Affiliation: Weintraub WS ( Christiana Care Health System, Newark, DE 19718, USA. wweintraub@christianacare.org) |
| Abstract | BACKGROUND: Questions persist concerning the comparative effectiveness of percutaneous coronary intervention (PCI) and coronary-artery bypass grafting (CABG). The American College of Cardiology Foundation (ACCF) and the Society of Thoracic Surgeons (STS) collaborated to compare the rates of long-term survival after PCI and CABG. METHODS: We linked the ACCF National Cardiovascular Data Registry and the STS Adult Cardiac Surgery Database to claims data from the Centers for Medicare and Medicaid Services for the years 2004 through 2008. Outcomes were compared with the use of propensity scores and inverse-probability-weighting adjustment to reduce treatment-selection bias. RESULTS: Among patients 65 years of age or older who had two-vessel or three-vessel coronary artery disease without acute myocardial infarction, 86,244 underwent CABG and 103,549 underwent PCI. The median follow-up period was 2.67 years. At 1 year, there was no significant difference in adjusted mortality between the groups (6.24% in the CABG group as compared with 6.55% in the PCI group; risk ratio, 0.95; 95% confidence interval [CI], 0.90 to 1.00). At 4 years, there was lower mortality with CABG than with PCI (16.4% vs. 20.8%; risk ratio, 0.79; 95% CI, 0.76 to 0.82). Similar results were noted in multiple subgroups and with the use of several different analytic methods. Residual confounding was assessed by means of a sensitivity analysis. CONCLUSIONS: In this observational study, we found that, among older patients with multivessel coronary disease that did not require emergency treatment, there was a long-term survival advantage among patients who underwent CABG as compared with patients who underwent PCI. (Funded by the National Heart, Lung, and Blood Institute.). |
| ISSN | 00284793 |
| e-ISSN | 15334406 |
| Journal | New England Journal of Medicine |
| Issue Number | 16 |
| Volume Number | 366 |
| Language | English |
| Publisher | Massachusetts Medical Society (United States) |
| Publisher Date | 2012-04-19 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Angioplasty, Balloon, Coronary Coronary Artery Bypass Coronary Disease Therapy Comparative Effectiveness Research Confounding Factors (Epidemiology) Mortality Surgery Databases, Factual Follow-Up Studies Observation Proportional Hazards Models Survival Analysis Comparative Study Research Support, N.I.H., Extramural Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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