Comparative effectiveness study shows how patient characteristics affect outcomes in coronary artery bypass graft surgery versus percutaneous coronary intervention<
Which coronary revascularization surgery provides the most mortality benefit may depend on individual patient characteristics. Researchers studied Medicare records for 105,156 patients undergoing multivessel coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) for coronary revascularization to assess whether patient clinical characteristics modify the comparative effectiveness of the procedures.
The researchers found that CABG was far more likely than PCI to reduce mortality for the average patient with multivessel coronary disease. However, the researchers found that several patient characteristics significantly modified the comparative effectiveness of the two procedures.
Patients with a history of peripheral arterial disease, tobacco use, diabetes, or heart failure fared better with CABG. Patients with none of those characteristics had better survival with PCI. According to the study authors, these findings underscore the need to personalize treatment recommendations for coronary revascularization among patients with multivessel coronary disease.