Objective: To compare the short- and long-term outcomes of percutaneous coronary intervention versus coronary artery bypass grafting in patients with severe left ventricular dilatation (LVD).
Methods: From July 2003 to September 2005, we enrolled 251 patients with severe LVD to undergo coronary revascularization with either PCI (n = 101) or CABG (n = 150) and analyzed the effects of different revascularization strategies on the in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE).
Results: Compared with those in the CABG group, the patients in the PCI group had lower incidence of in-hospital MACCE events [3.0% (3/101) vs 10.7% (16/150), P = 0.024], due mainly to a lower in-hospital mortality (2.0%vs 8.7%, P = 0.028). Ninety-nine (98.0%) patients in the PCI group and 136 (90.7%) patients in the CABG group were followed up for (516 ± 182) days and (515 ± 231) days, respectively. Although no difference existed in the follow-up incidence of MACCE between two groups, the PCI patients had a trend of a higher incidence of MACCE events [18.2% (18/99) vs 9.6% (13/136), P = 0.054], due mainly to a higher rate of repeat revascularization [14 (14.1%) vs (0.7%), P < 0.01]. Two patients groups had the comparable follow-up rates of mortality [4 (4.0%) vs 12 (8.8%), P = 0.151], myocardial infarction [2 (2.0%) vs 1 (0.7%), P = 0.781] and stroke [2 (2.0%) vs 0 (0.0%), P = 0.176].
Conclusion: For the patients with severe LVD. PCI is both safe and feasible. And it has a lower rate of in-hospital mortality, and a comparable incidence of follow-up MACCE events. However, the rate of follow-up repeat revascularization is higher.