Age, sex do not affect outcomes after PCI, CABG
Age and sex do not appear to influence outcomes after percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG) for left main coronary artery (LMCA) disease, reports a recent study.
The study included 4,001 LMCA patients who underwent either PCI (n=2,615; mean age, 63.7±10.8 years; 77.3 percent male) or CABG (n=1,386; mean age, 64.6±9.1 years; 77.8 percent male) for treatment. Participants were divided according to tertiles of age (<60, 60–69, ≥70 years) and according to sex. The primary outcome was a composite of death from any cause, stroke or myocardial infarction.
Over a median follow-up of 6.3 years, the primary composite endpoint occurred significantly more frequently in patients who received CABG vs PCI (14.5 percent vs 10.8 percent; p=0.001). This was also true in males (15.0 percent vs 11.0 percent; p=0.002) but not in females (12.8 percent vs 10.1 percent; p=0.17).
The difference in incidence of the primary outcome was only significant in participants aged <60 years (CABG vs PCI: 7.7 percent vs 4.0 percent; p=0.009).
However, multivariable Cox regression analysis found that there was no significant difference in the risk of the primary composite outcome between the PCI and CABG groups (adjusted hazard ratio [HR], 0.94, 95 percent CI, 0.75–1.16; p=0.55). This remained consistent across all age groups examined (p-interaction=0.57).
Stratifying according to sex likewise yielded meaningful changes. The risk of the primary outcome was comparable between PCI and CABG in both males (adjusted HR, 0.92, 0.72–1.17; p=0.47) and females (adjusted HR, 0.89, 0.52–1.50; p=0.65; p-interaction with sex=0.65).