Ischemic Heart Disease
Conditions
Keywords
Ischemic heart disease, Coronary artery bypass grafting, Percutaneous coronary intervention
Brief summary
1. To evaluate the long-term clinical outcomes and prognostic factors in patients with coronary artery disease undergoing coronary artery bypass graft surgery. 2. To evaluate the long-term clinical outcomes and prognostic factors in patients with coronary artery disease undergoing percutaneous coronary intervention with drug-eluting stent.
Detailed description
Coronary artery disease (CAD) still remains one of the world's leading causes of death, despite markedly improvement of devices and technologies on past several decades. The treatment strategy for CAD included medical treatment, percutaneous coronary intervention (PCI), and coronary-artery bypass grafting (CABG). CABG is a procedure in which autologous arteries or veins are used as grafts to bypass coronary arteries that are partially or completely obstructed by atherosclerotic plaque. During the past decade, there has been nearly a 30% decline in CABG procedures, despite abundant evidence to support the effectiveness and safety of the operation.This decline has been accompanied by a corresponding increase in PCI. To date, there have been numerous studies to compare the clinical outcomes between PCI and CABG for patients with CAD. Among them, SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) trial demonstrated CABG is associated with lower incidence of major adverse cardiac and cerebrovascualr events in patients with high SYNTAX score, compared with PCI. In this regard, the current guidelines recommend that CABG is preferred method for care of stable ischemic heart disease patients with three-vessel or left main coronary artery disease. However, most randomized controlled studies do not reflect the contemporary practice, because they have been performed in the era of bare metal stents or first-generation drug-eluting stent (DES). In addition, there have been limited data regarding the prognostic factors for long-term clinical outcomes in patients undergoing PCI with DES or CABG. Therefore, the investigators sought to compare the clinical outcomes between PCI with DES or CABG, and to identify prognostic factors for long-term clinical outcomes in patients who underwent PCI with DES or CABG.
Interventions
PROCEDUREPCI
Patients who undergoing PCI with DES
PROCEDURECABG
Patients who undergoing CABG
Sponsors
Samsung Medical Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who suspected ischemic heart disease and underwent CABG or PCI with DES
Exclusion criteria
* Age \< 18 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac Death | 5-Year after the index procedure | death from cardiac-cause |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Myocardial infarction | 5-Year after the index procedure | Myocardial infarction without peri-procedural myocardial infarction |
| Target-vessel revascularization | 5-Year after the index procedure | ischemia-driven or all |
| Any revascularization | 5-Year after the index procedure | ischemia-driven or all |
| All-cause Death | 5-Year after the index procedure | death from any-cause |
| Cerebrovascular accident | 5-Year after the index procedure | Ischemic or hemorrhagic |
| MACCE (major adverse cardiac and cerebrovascular accident) | 5-Year after the index procedure | a composite of death, myocardial infarction, and cerebrovascular accident |
| Bleeding | 5-Year after the index procedure | BARC type 2-5 |
Countries
South Korea
Contacts
Primary ContactYoung Bin Song, MD, PhD
Backup ContactKi Hong Choi, MD
Outcome results
None listed