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Long-term Outcomes and Prognostic Factors in Patient Undergoing CABG or PCI

Recruiting
Conditions
Ischemic Heart Disease
Interventions
Procedure: PCI
Procedure: CABG
Registration Number
NCT03870815
Lead Sponsor
Samsung Medical Center
Brief Summary

1. To evaluate the long-term clinical outcomes and prognostic factors in patients with coronary artery disease undergoing coronary artery bypass graft surgery.

2. To evaluate the long-term clinical outcomes and prognostic factors in patients with coronary artery disease undergoing percutaneous coronary intervention with drug-eluting stent.

Detailed Description

Coronary artery disease (CAD) still remains one of the world's leading causes of death, despite markedly improvement of devices and technologies on past several decades. The treatment strategy for CAD included medical treatment, percutaneous coronary intervention (PCI), and coronary-artery bypass grafting (CABG). CABG is a procedure in which autologous arteries or veins are used as grafts to bypass coronary arteries that are partially or completely obstructed by atherosclerotic plaque. During the past decade, there has been nearly a 30% decline in CABG procedures, despite abundant evidence to support the effectiveness and safety of the operation.This decline has been accompanied by a corresponding increase in PCI. To date, there have been numerous studies to compare the clinical outcomes between PCI and CABG for patients with CAD. Among them, SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) trial demonstrated CABG is associated with lower incidence of major adverse cardiac and cerebrovascualr events in patients with high SYNTAX score, compared with PCI. In this regard, the current guidelines recommend that CABG is preferred method for care of stable ischemic heart disease patients with three-vessel or left main coronary artery disease. However, most randomized controlled studies do not reflect the contemporary practice, because they have been performed in the era of bare metal stents or first-generation drug-eluting stent (DES). In addition, there have been limited data regarding the prognostic factors for long-term clinical outcomes in patients undergoing PCI with DES or CABG. Therefore, the investigators sought to compare the clinical outcomes between PCI with DES or CABG, and to identify prognostic factors for long-term clinical outcomes in patients who underwent PCI with DES or CABG.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
10000
Inclusion Criteria
  • Patients who suspected ischemic heart disease and underwent CABG or PCI with DES
Exclusion Criteria
  • Age < 18 years

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PCIPCIPatients with CAD who undergoing PCI with DES
CABGCABGPatients with CAD who undergoing CABG
Primary Outcome Measures
NameTimeMethod
Cardiac Death5-Year after the index procedure

death from cardiac-cause

Secondary Outcome Measures
NameTimeMethod
Bleeding5-Year after the index procedure

BARC type 2-5

All-cause Death5-Year after the index procedure

death from any-cause

MACCE (major adverse cardiac and cerebrovascular accident)5-Year after the index procedure

a composite of death, myocardial infarction, and cerebrovascular accident

Myocardial infarction5-Year after the index procedure

Myocardial infarction without peri-procedural myocardial infarction

Target-vessel revascularization5-Year after the index procedure

ischemia-driven or all

Cerebrovascular accident5-Year after the index procedure

Ischemic or hemorrhagic

Any revascularization5-Year after the index procedure

ischemia-driven or all

Trial Locations

Locations (1)

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

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