Evolution of the Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG) Indication and Mortality Rates in Spain from 2010 to 2019.

IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Development and Disease Pub Date : 2024-11-16 DOI:10.3390/jcdd11110369
Óscar Gasulla, Antonio Sarría-Santamera, Ferran A Mazaira-Font, Cielo García-Montero, Oscar Fraile-Martinez, Diego Cantalapiedra, Manuel F Carrillo-Rodríguez, Belen Gómez-Valcárcel, Miguel Á Ortega, Melchor Álvarez-Mon, Angel Asúnsolo
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Abstract

Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are the main interventional treatments for coronary artery disease (CAD) patients. Both procedures are constantly being perfected and developed. This study aims to analyze the evolution of intervention mortality rates of PCI and CABG in recent years in Spain. We use a database of all hospital discharges from CABG and PCI procedures in Spain during two periods, between the years 2010 to 2012 and 2016 to 2019. We elaborate two multivariate regression logistic models to test the differences in mortality between the two periods and the two procedures, adjusting the mortality rates by age, gender, and comorbidities. We find strong evidence that CABG significantly reduced mortality rates, especially in complex patients, while PCI remained almost constant. We also discuss how physicians incorporate the improvement in procedures' performance into the decision-making for the recommendation of these two procedures in CAD patient management.

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2010 至 2019 年西班牙经皮冠状动脉介入治疗 (PCI) 和冠状动脉旁路移植术 (CABG) 适应症和死亡率的演变。
经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)是冠状动脉疾病(CAD)患者的主要介入治疗方法。这两种治疗方法都在不断完善和发展。本研究旨在分析近年来西班牙 PCI 和 CABG 介入死亡率的变化情况。我们使用的数据库包含 2010 年至 2012 年和 2016 年至 2019 年两个时期内西班牙所有 CABG 和 PCI 手术的出院病例。我们建立了两个多元回归逻辑模型来检验两个时期和两种手术之间死亡率的差异,并根据年龄、性别和合并症调整了死亡率。我们发现有力的证据表明,CABG 大幅降低了死亡率,尤其是复杂患者的死亡率,而 PCI 几乎保持不变。我们还讨论了医生如何将程序性能的改善纳入决策中,以便在 CAD 患者管理中推荐这两种程序。
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来源期刊
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
12.50%
发文量
381
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