Comparing 5-year outcomes of aorta-coronary bypass surgery and percutaneous coronary intervention performed with new-generation drug-eluting stents in non-diabetic patients with multivessel acute coronary syndrome patients and intermediate syntax score

Abstract

Objective: Our main objective is to determine the difference between patients undergoing CABG and PCI with new-generation drug-eluting stents who were non-diabetic during the course of a multivessel acute coronary syndrome (ACS) and intermediate SYNTAX score. Methods: Between 2012 and 2014, we retrospectively evaluated 1011 non-diabetic patients with ACS in a single center. The patients were followed up up to 5-years. All-cause mortality, cardiac death, myocardial infarction, stroke, revascularization and stent thrombosis were recorded accordingly. Results: A total of 516 (51%) patients were included in the PCI group and 495 patients (49%) in the CABG group. Stroke occurrence (PCI group: 0.8%, and CABG group: 2.6%, p=0.022), requirement for recurrent revascularizations (PCI group: 13.6%, and CABG group: 8.1%, p=0.005) and the MACE percentage (PCI group: 20.3%, and CABG group: 14.5%, p=0.015) were statistically significant between two groups. However, there was no statistical significance difference between two groups in terms of primary endpoints including death, MI, and stroke (PCI group: 10.9%, and CABG group: 8.3%, p=0.165) and all-cause mortality PCI group 6.2%, and CABG group: 4.7%, p=0.298). Conclusion: There was no difference in all-cause mortality and myocardial infarction between the PCI and the CABG groups during 5-year follow-up. The frequency of repeated revascularizations was lower in the CABG group than the PCI group. In contrast, the stroke rates were higher in the CABG group. © Istanbul Medeniyet University Faculty of Medicine.