Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting for Patients with Multivessel Coronary Artery Disease: The Korean Multicenter Revascularization Registry(KORR)

ABSTRACT

BACKGROUND AND OBJECTIVE: Despite many multicenter trials on percutaneous coronary intervention (PCI), versus coronary artery bypass surgery (CABG), in multivessel coronary artery disease (MVCAD), the most appropriate treatment remains a matter of debate. Moreover, studies comparing the 2 strategies in eastern society are rare. The aim of this study was to assess the relative merits of PCI and CABG in MVCAD in the post-stent era. SUBJECTS AND METHODS: Patients, with MVCAD, indicated for revascularization were enrolled from 9 centers in Korea. Out of the 3,279 patients in the registry, 2102 (CABG 609 patients, PCI 1,493 patients) were selected for a comparison of their outcomes, after a statistical adjustments for the disparity for 6 independent risk factors, for the prognosis between the two groups. RESULTS: There was no significantly different in the 3 year survival rates between PCI and CABG groups. In the diabetic patients, the 3-year mortality rate in PCI group was 1.6-fold higher than in the CABG group, although it was not statistically significant (PCI 19.8%, CABG 12.5%, p=0.24). The incidence of cerebrovascular events (CVE) was higher in the CABG group. The thirty-day death rate, myocardial infarction or CVE were higher in the CABG group (PCI 1.3%, CABG 4.2%, p<0.001). Both the long and short-term revascularization rates were higher in PCI group compared to CABG group. CONCLUSION: Our Korean registry demonstrated a comparable survival rate between the PCI and CABG groups. A PCI was associated with a lower early morbidity, but with a greater need for repeated revascularization compared to a CABG.