HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yaron Moshkovitz Dan Loberman Gideon Uretzky Yanai Ben-Gal Rephael Mohr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Herz, I. Articles by Mohr, R. Search for Related Content PubMed PubMed Citation Articles by Herz, I. Articles by Mohr, R. Related Collections Coronary disease

Ann Thorac Surg 2005;80:2086-2090
© 2005 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Drug-Eluting Stents Versus Bilateral Internal Thoracic Grafting for Multivessel Coronary Disease

^a Department of Cardiology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University
^b Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University
^c Departments of Cardiology and Cardiac Surgery, Assuta Medical Center, Tel Aviv
^d Center for Quality, Safety and Data, Hadassah Hebrew University Hospital, Ein Karem, Jerusalem, Israel

Accepted for publication May 17, 2005.

^_* Address correspondence to Dr Mohr, Dept of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel (Email: marion{at}tasmc.health.gov.il).

BACKGROUND: Reduction of restenosis and reinterventions was recently reported with percutaneous interventions (PCI), including drug-eluting stents (Cypher; Cordis, Miami Lakes, FL). This study compares results of multivessel Cypher stenting with those of bilateral internal thoracic artery (BITA) grafting.

METHODS: From January 2002 to June 2004, 768 consecutive patients underwent multivessel myocardial revascularization; 138 by PCI including Cyphers and 630 by BITA. After matching for age, sex, ejection fraction, extent of coronary disease, and congestive heart failure, two groups (113 patients each) were used to compare the two revascularization modalities.

RESULTS: Both groups were similar; however, left main and intraaortic balloon were more prevalent in the BITA group. The number of coronary vessels treated per patient was higher in the BITA group (2.87 vs 2.22, p < 0.001). Follow-up ranged between 6 and 34 months. Thirty-day mortality was 0.9% in the BITA and zero in the PCI group (p = 0.32). There were no late deaths in the BITA and three (2.7%) in the Cypher group (p = 0.08). Angina returned in 28.3% of the Cypher and 12.4% of the BITA group, p = 0.003. A Cox proportional hazard model revealed assignment to the Cypher group to be the only predictor of angina recurrence (odds ratio 2.78, 95% confidence interval 1.46-2.56). There were 16 (14.2%) reinterventions in the Cypher group compared with six (5.3%) in the BITA group. One-year reintervention-free survival (Kaplan-Meier) of the BITA was 96% compared with 86.6% in the Cypher group (p = 0.005, log-rank test).

CONCLUSIONS: Despite improved results of PCI with Cyphers, midterm clinical outcome of multivessel patients treated with BITA is still better.

This article has been cited by other articles:

				J. S. Rankin, R. H. Tuttle, A. S. Wechsler, T. L. Teichmann, D. D. Glower, and R. M. Califf Techniques and Benefits of Multiple Internal Mammary Artery Bypass at 20 Years of Follow-Up Ann. Thorac. Surg., March 1, 2007; 83(3): 1008 - 1015. [Abstract] [Full Text] [PDF]

				H. B. Barner Status of percutaneous coronary intervention and coronary artery bypass. Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 419 - 424. [Abstract] [Full Text] [PDF]