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3 results on '"life expectancy, long-term outcome, PCI"'

1. 10-Year Follow-Up After Revascularization in Elderly Patients With Complex Coronary Artery Disease.

Author

Ono, Masafumi, Serruys, Patrick W., Hara, Hironori, Kawashima, Hideyuki, Gao, Chao, Wang, Rutao, Takahashi, Kuniaki, O'Leary, Neil, Wykrzykowska, Joanna J., Sharif, Faisal, Piek, Jan J., Garg, Scot, Mack, Michael J., Holmes, David R., Morice, Marie-Claude, Head, Stuart J., Kappetein, Arie Pieter, Thuijs, Daniel J.F.M., Noack, Thilo, and Davierwala, Piroze M.

Subjects
*OLDER patients, *CORONARY artery bypass, *SURVIVAL rate, *OLDER people, *QUALITY of life, *RESEARCH, *LIFE expectancy, *RESEARCH methodology, *MEDICAL care, *ACQUISITION of data, *MEDICAL cooperation, *EVALUATION research, *CARDIOVASCULAR system, *COMPARATIVE studies, *CORONARY artery disease, *QUESTIONNAIRES, *LONGITUDINAL method, *DISEASE complications
Abstract

Background: The optimal revascularization strategy for the elderly with complex coronary artery disease remains unclear.Objectives: The goal of this study was to investigate 10-year all-cause mortality, life expectancy, 5-year major adverse cardiac or cerebrovascular events (MACCE), and 5-year quality of life (QOL) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in elderly individuals (>70 years old) with 3-vessel disease (3VD) and/or left main disease (LMD).Methods: In the present pre-specified analysis on age of the SYNTAX Extended Survival study, 10-year all-cause death and 5-year MACCE were compared with Kaplan-Meier estimates and Cox proportional hazards models among elderly or nonelderly patients. Life expectancy was estimated by restricted mean survival time within 10 years, and QOL status according to the Seattle Angina Questionnaire up to 5 years was assessed by linear mixed-effects models.Results: Among 1,800 randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality did not differ significantly between PCI and CABG in elderly (44.1% vs. 41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to 1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to 1.69; pinteraction = 0.332). Among elderly patients, 5-year MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95% CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to 2.10; pinteraction = 0.043). There were no significant difference in life expectancy (mean difference: 0.2 years in favor of CABG; 95% CI: -0.4 to 0.7) and 5-year QOL status between PCI and CABG among elderly patients.Conclusions: Elderly patients with 3VD and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year MACCE, and 5-year QOL status irrespective of revascularization mode. (Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050) (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972). [ABSTRACT FROM AUTHOR]

Published
2021
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3. 10-Year Follow-Up After Revascularization in Elderly Patients With Complex Coronary Artery Disease

Author

Friedrich W. Mohr, Hideyuki Kawashima, Kuniaki Takahashi, Syntax Extended Survival Investigators, Faisal Sharif, Arie Pieter Kappetein, Jan J. Piek, Michael J. Mack, J J Wykrzykowska, David R. Holmes, Scot Garg, Marie-Claude Morice, David Cohen, Masafumi Ono, Chao Gao, Daniel J F M Thuijs, Neil O'Leary, Stuart J. Head, Rutao Wang, Yoshinobu Onuma, Hironori Hara, Patrick W. Serruys, Thilo Noack, Piroze M. Davierwala, Graduate School, Cardiology, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, and Cardiothoracic Surgery

Subjects
long-term outcome, Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Revascularization, THERAPY, elderly, Angina, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Life Expectancy, Percutaneous Coronary Intervention, Quality of life, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Humans, 030212 general & internal medicine, Registries, Coronary Artery Bypass, CABG, Aged, Aged, 80 and over, OUTCOMES, business.industry, Proportional hazards model, Hazard ratio, Percutaneous coronary intervention, SYNTAX, PCI, BYPASS GRAFT-SURGERY, Middle Aged, medicine.disease, humanities, Europe, Conventional PCI, North America, Cardiology, Quality of Life, life expectancy, long-term outcome, PCI, TRIAL, Female, Cardiology and Cardiovascular Medicine, business, INTERVENTION, Follow-Up Studies
Abstract

Background: The optimal revascularization strategy for the elderly with complex coronary artery disease remains unclear. Objectives: The goal of this study was to investigate 10-year all-cause mortality, life expectancy, 5-year major adverse cardiac or cerebrovascular events (MACCE), and 5-year quality of life (QOL) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in elderly individuals (>70 years old) with 3-vessel disease (3VD) and/or left main disease (LMD). Methods: In the present pre-specified analysis on age of the SYNTAX Extended Survival study, 10-year all-cause death and 5-year MACCE were compared with Kaplan-Meier estimates and Cox proportional hazards models among elderly or nonelderly patients. Life expectancy was estimated by restricted mean survival time within 10 years, and QOL status according to the Seattle Angina Questionnaire up to 5 years was assessed by linear mixed-effects models. Results: Among 1,800 randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality did not differ significantly between PCI and CABG in elderly (44.1% vs. 41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to 1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to 1.69; pinteraction = 0.332). Among elderly patients, 5-year MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95% CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to 2.10; pinteraction = 0.043). There were no significant difference in life expectancy (mean difference: 0.2 years in favor of CABG; 95% CI: −0.4 to 0.7) and 5-year QOL status between PCI and CABG among elderly patients. Conclusions: Elderly patients with 3VD and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year MACCE, and 5-year QOL status irrespective of revascularization mode. (Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050) (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972)

Published
2021

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