Long-term survival after coronary bypass surgery and percutaneous coronary intervention

Objectives To assess whether there exists a long-term difference in survivalafter treatment with coronary bypass surgeryor percutaneous coronary interventionin patients with coronary disease as judged by all-cause mortality. Methods Retrospective study from the Feiring Heart Clinic database of survivalin 22 880 patients—15 078 treated with percutaneous coronary interventionand 7802 with bypass surgeryfollowed up to 16 years. Results Cox regression and propensity score analysis showed no difference in survivalfor one-vessel and two-vessel disease during the whole study period. In three-vessel disease, however, the analysis revealed a consistent and highly significant survivalbenefit in the first 8 years with an HR of 0.76 (95% CI 0.69 to 0.84, p<0.001) in favour of bypass surgerywith similar survivalrates in the two treatment strategies after that time period. Conclusions Treatment strategy did not affect survivalin one-vessel and two-vessel disease, but bypass surgeryoffered an improved survivalin the first 8 years in patients with three-vessel disease. These results are consistent with most previous reports and the survivalbenefit should be taken into account when selecting a strategy for this patient group.