BACKGROUND: Patients with multivessel disease treated percutaneously have similar outcomes when compared to those submitted to surgical procedures in terms of major cardiac events, although the former require new revascularization procedures more frequently. OBJECTIVE: To assess long-term clinical outcomes after coronary artery bypass graft (CABG) for the treatment of multivessel disease versus surgical procedures to treat multivessel disease determining death, AMI, and stroke incidence rates, as well as new interventions. METHODS: A randomized study carried out between April, 1997 and June, 1998 included 66 patients submitted to non-drug eluting stenting (33P) and surgery (33P). RESULTS: Clinical follow-up results after 8 years have shown no significant difference between the two groups in terms of survival free of MACE events (death, stroke or AMI): STENTING: 74% X CABG: 85.1%; p= not significant). Additional revascularizations were more frequent in the stenting group as compared to the surgery group (15 P - 45% x 5 P - 15%, respectively, p=0.01). Consequently, survival rates without MACE and repeated revascularization was significantly lower in patients assigned to stenting when compared to those assigned to CABG (49% x 80.5%, respectively, p=0.0082). CONCLUSION: Percutaneous revascularization with non-drug eluting stenting for the treatment of multivessel disease offers the same degree of protection against MACE (death, stroke and AMI) as compared to CABG. However, stenting is associated with a greater need of repeated revascularization and lower total event-free survival rates.
Coronary disease; Stents; Myocardial revascularization; Cardiac surgical procedures
