Outcomes following coronary artery bypass grafting and percutaneous transluminal coronary angioplasty in the stent era: a prospective study of all 9890 consecutive patients operated on in Scotland over a two year period.

J. P. Pell, D. Walsh, John David Norrie

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    28 Citations (Scopus)

    Abstract

    Objective - To determine current outcomes of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG).

    Design - The Scottish coronary revascularisation register provided prospectively collected data on case mix and in-hospital complications for all revascularisation procedures between April 1997 and March 1999 (4775 PTCA; 5115 CABG). Linkage to routine hospital discharge and death data provided follow up information on survival and repeat revascularisation.

    Results - Stents were used in 51% of PTCA procedures. CABG patients were older, had more severe coronary disease, and had greater comorbidity PTCA was more likely to be undertaken as an urgent or emergency procedure. Perioperative death and urgent surgery followed 0.3% and 0.6% of PTCA procedures, respectively. Case fatality rates were higher following CABG, with 6.7% dead within two years compared with 3.4% following PTCA. PTCA was more often followed by readmission for ischaemic heart disease, repeat angiography, or revascularisation: 22.8% of patients had repeat revascularisation within two years, compared with 1.8% following CABG.

    Conclusions - The severity of coronary heart disease was greater than in previously published registry studies and randomised trials. Despite this, overall survival figures were comparable and repeat revascularisation rates lower, particularly following PTCA. Perioperative death and urgent surgery following PTCA were also lower. These favourable outcomes may be attributable, in part, to increased use of bail our and elective stenting.

    Original languageEnglish
    Pages (from-to)662-666
    Number of pages4
    JournalHeart
    Volume85
    Issue number6
    DOIs
    Publication statusPublished - 2001

    Keywords

    • percutaneous transluminal coronary angioplasty
    • coronary artery bypass grafting
    • survival
    • outcome
    • DIABETIC-PATIENTS
    • RANDOMIZED TRIAL
    • SURGERY
    • DISEASE
    • REVASCULARIZATION
    • SURVIVAL

    Cite this

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    title = "Outcomes following coronary artery bypass grafting and percutaneous transluminal coronary angioplasty in the stent era: a prospective study of all 9890 consecutive patients operated on in Scotland over a two year period.",
    abstract = "Objective - To determine current outcomes of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG).Design - The Scottish coronary revascularisation register provided prospectively collected data on case mix and in-hospital complications for all revascularisation procedures between April 1997 and March 1999 (4775 PTCA; 5115 CABG). Linkage to routine hospital discharge and death data provided follow up information on survival and repeat revascularisation.Results - Stents were used in 51{\%} of PTCA procedures. CABG patients were older, had more severe coronary disease, and had greater comorbidity PTCA was more likely to be undertaken as an urgent or emergency procedure. Perioperative death and urgent surgery followed 0.3{\%} and 0.6{\%} of PTCA procedures, respectively. Case fatality rates were higher following CABG, with 6.7{\%} dead within two years compared with 3.4{\%} following PTCA. PTCA was more often followed by readmission for ischaemic heart disease, repeat angiography, or revascularisation: 22.8{\%} of patients had repeat revascularisation within two years, compared with 1.8{\%} following CABG.Conclusions - The severity of coronary heart disease was greater than in previously published registry studies and randomised trials. Despite this, overall survival figures were comparable and repeat revascularisation rates lower, particularly following PTCA. Perioperative death and urgent surgery following PTCA were also lower. These favourable outcomes may be attributable, in part, to increased use of bail our and elective stenting.",
    keywords = "percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, survival, outcome, DIABETIC-PATIENTS, RANDOMIZED TRIAL, SURGERY, DISEASE, REVASCULARIZATION, SURVIVAL",
    author = "Pell, {J. P.} and D. Walsh and Norrie, {John David}",
    year = "2001",
    doi = "10.1136/heart.85.6.662",
    language = "English",
    volume = "85",
    pages = "662--666",
    journal = "Heart",
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    number = "6",

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    TY - JOUR

    T1 - Outcomes following coronary artery bypass grafting and percutaneous transluminal coronary angioplasty in the stent era: a prospective study of all 9890 consecutive patients operated on in Scotland over a two year period.

    AU - Pell, J. P.

    AU - Walsh, D.

    AU - Norrie, John David

    PY - 2001

    Y1 - 2001

    N2 - Objective - To determine current outcomes of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG).Design - The Scottish coronary revascularisation register provided prospectively collected data on case mix and in-hospital complications for all revascularisation procedures between April 1997 and March 1999 (4775 PTCA; 5115 CABG). Linkage to routine hospital discharge and death data provided follow up information on survival and repeat revascularisation.Results - Stents were used in 51% of PTCA procedures. CABG patients were older, had more severe coronary disease, and had greater comorbidity PTCA was more likely to be undertaken as an urgent or emergency procedure. Perioperative death and urgent surgery followed 0.3% and 0.6% of PTCA procedures, respectively. Case fatality rates were higher following CABG, with 6.7% dead within two years compared with 3.4% following PTCA. PTCA was more often followed by readmission for ischaemic heart disease, repeat angiography, or revascularisation: 22.8% of patients had repeat revascularisation within two years, compared with 1.8% following CABG.Conclusions - The severity of coronary heart disease was greater than in previously published registry studies and randomised trials. Despite this, overall survival figures were comparable and repeat revascularisation rates lower, particularly following PTCA. Perioperative death and urgent surgery following PTCA were also lower. These favourable outcomes may be attributable, in part, to increased use of bail our and elective stenting.

    AB - Objective - To determine current outcomes of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG).Design - The Scottish coronary revascularisation register provided prospectively collected data on case mix and in-hospital complications for all revascularisation procedures between April 1997 and March 1999 (4775 PTCA; 5115 CABG). Linkage to routine hospital discharge and death data provided follow up information on survival and repeat revascularisation.Results - Stents were used in 51% of PTCA procedures. CABG patients were older, had more severe coronary disease, and had greater comorbidity PTCA was more likely to be undertaken as an urgent or emergency procedure. Perioperative death and urgent surgery followed 0.3% and 0.6% of PTCA procedures, respectively. Case fatality rates were higher following CABG, with 6.7% dead within two years compared with 3.4% following PTCA. PTCA was more often followed by readmission for ischaemic heart disease, repeat angiography, or revascularisation: 22.8% of patients had repeat revascularisation within two years, compared with 1.8% following CABG.Conclusions - The severity of coronary heart disease was greater than in previously published registry studies and randomised trials. Despite this, overall survival figures were comparable and repeat revascularisation rates lower, particularly following PTCA. Perioperative death and urgent surgery following PTCA were also lower. These favourable outcomes may be attributable, in part, to increased use of bail our and elective stenting.

    KW - percutaneous transluminal coronary angioplasty

    KW - coronary artery bypass grafting

    KW - survival

    KW - outcome

    KW - DIABETIC-PATIENTS

    KW - RANDOMIZED TRIAL

    KW - SURGERY

    KW - DISEASE

    KW - REVASCULARIZATION

    KW - SURVIVAL

    U2 - 10.1136/heart.85.6.662

    DO - 10.1136/heart.85.6.662

    M3 - Article

    VL - 85

    SP - 662

    EP - 666

    JO - Heart

    JF - Heart

    SN - 1355-6037

    IS - 6

    ER -