Our Summary

This study looked at the long-term health outcomes of patients with a specific heart condition, known as three-vessel coronary artery disease. Two treatments were compared: percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The research found that patients who underwent PCI had a higher risk of death than those who underwent CABG. This was not due to an increased risk of death from heart-related issues, but rather from non-cardiovascular causes. The risk of heart attacks was also higher in the PCI group, but there was no significant difference in the risk of stroke between the two treatments. These findings are based on real-world data from Japan.

FAQs

  1. What is the main difference in health outcomes between patients who had PCI and CABG treatments?
  2. Did the study find an increased risk of stroke in either the PCI or CABG groups?
  3. What type of heart condition was specifically studied in this research?

Doctor’s Tip

A doctor might tell a patient considering CABG (coronary artery bypass grafting) that this procedure has been shown to have better long-term outcomes compared to other treatments for certain heart conditions, such as three-vessel coronary artery disease. It is important to discuss all treatment options with your doctor and make an informed decision based on your individual health needs and risks. Additionally, following a healthy lifestyle, including regular exercise, a balanced diet, and avoiding smoking, can help improve the success of the procedure and overall heart health.

Suitable For

Patients with three-vessel coronary artery disease are typically recommended CABG as it has been shown to have better long-term health outcomes compared to PCI. Additionally, patients who are at a higher risk of death from non-cardiovascular causes may also be recommended CABG over PCI. Overall, CABG is often recommended for patients with more complex or severe coronary artery disease as it is a more effective treatment option for these individuals.

Timeline

Before CABG:

  1. Patient is diagnosed with three-vessel coronary artery disease.
  2. Patient undergoes various diagnostic tests such as angiography to determine the extent of blockages in the coronary arteries.
  3. Patient may undergo medical management to control symptoms and prevent further progression of the disease.
  4. If deemed necessary, patient is scheduled for CABG surgery after consultation with a cardiac surgeon.

After CABG:

  1. Patient undergoes CABG surgery, during which the surgeon takes a healthy blood vessel from another part of the body and uses it to bypass the blocked coronary arteries.
  2. Patient is monitored closely in the intensive care unit immediately after surgery.
  3. Patient is gradually weaned off mechanical ventilation and medications to support heart function.
  4. Patient undergoes cardiac rehabilitation to regain strength and endurance.
  5. Patient is discharged from the hospital and continues to follow up with their healthcare team for long-term monitoring and management of their heart disease.
  6. Patient may experience improvements in symptoms such as chest pain and shortness of breath, as well as a reduced risk of heart attacks and other cardiac events in the long term.

What to Ask Your Doctor

  1. What is three-vessel coronary artery disease and how does it affect my heart health?
  2. What is the difference between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in terms of treatment?
  3. Why is CABG recommended for patients with three-vessel coronary artery disease over PCI?
  4. What are the potential risks and complications associated with CABG?
  5. How long is the recovery process after undergoing CABG?
  6. How will CABG improve my long-term health outcomes compared to other treatment options?
  7. Are there any lifestyle changes or medications I should consider after undergoing CABG?
  8. How often will I need follow-up appointments or monitoring after the surgery?
  9. Are there any specific factors in my medical history that may affect the success of CABG?
  10. What are the success rates of CABG in patients with three-vessel coronary artery disease?

Reference

Authors: Matsumura-Nakano Y, Shiomi H, Morimoto T, Yamaji K, Ehara N, Sakamoto H, Takeji Y, Yoshikawa Y, Yamamoto K, Imada K, Tada T, Taniguchi R, Nishikawa R, Tada T, Uegaito T, Ogawa T, Yamada M, Takeda T, Eizawa H, Tamura N, Tambara K, Suwa S, Shirotani M, Tamura T, Inoko M, Nishizawa J, Natsuaki M, Sakai H, Yamamoto T, Kanemitsu N, Ohno N, Ishii K, Marui A, Tsuneyoshi H, Terai Y, Nakayama S, Yamazaki K, Takahashi M, Tamura T, Esaki J, Miki S, Onodera T, Mabuchi H, Furukawa Y, Tanaka M, Komiya T, Soga Y, Hanyu M, Ando K, Kadota K, Minatoya K, Nakagawa Y, Kimura T; On behalf the CREDO-Kyoto PCI/CABG Registry Cohort-3 Investigators. Journal: Am J Cardiol. 2021 Apr 15;145:25-36. doi: 10.1016/j.amjcard.2020.12.076. Epub 2021 Jan 14. PMID: 33454340