Journal Article

DZNE-2022-01611

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Stents versus bypass surgery: 3-year mortality risk of patients with coronary interventions aged 50+ in Germany.

Nestler, S. ; Kreft, D.DZNE* ; Donndorf, P. ; Ince, H. ; Doblhammer, G.

2022
BioMed Central London

This record in other databases:    

Please use a persistent id in citations: doi:10.1186/s13019-022-02014-2

Abstract: Due to demographic aging, the prevalence of coronary artery disease (CAD) is expected to increase in the future, resulting in a growing demand for stent and bypass interventions. This study aims to investigate the mortality risk of patients following conventional coronary artery bypass grafting (CABG) or endovascular procedure by the implantation of bare-metal stents (BMS) or drug-eluting stents (DES).Based on a random sample of 250,000 members of Germany's largest health insurance 'Allgemeine Ortskrankenkassen' (AOK) from 2004 to 2015, incident CAD patients were analyzed by Cox Proportional-Hazard models. Risk adjustment was made for sex, age, other cardiac diseases, non-cardiovascular comorbidities and years since intervention. Due to later admission of DES and thus a shorter observation time, mortality was examined for 3 years since the intervention.BMS represented the most frequent procedure (48%). We found similar proportions of CABG (19%) and DES interventions (23%). After risk adjustment, the models showed a 21% (p = 0.004) lower mortality risk of patients with DES and also a 21% (p = 0.002) lower mortality risk of CABG patients compared to persons with BMS.Based on a large-scale dataset, our study demonstrated survival advantages of CABG and DES interventions over BMS, with no differences between the DES and CABG groups. The results help to assess the risks of coronary interventions. Aspects of quality of life, severity of postoperative physical limitations, duration of rehabilitation, patients' preferences, and aspects of cost-effectiveness for hospitals and society should be further considered.

Keyword(s): Coronary Artery Disease (MeSH) ; Drug-Eluting Stents (MeSH) ; Germany: epidemiology (MeSH) ; Humans (MeSH) ; Myocardial Infarction: etiology (MeSH) ; Percutaneous Coronary Intervention: methods (MeSH) ; Quality of Life (MeSH) ; Risk Factors (MeSH) ; Stents: adverse effects (MeSH) ; Treatment Outcome (MeSH) ; Coronary artery bypass ; Coronary artery disease ; Follow-up ; Health claims data ; Mortality ; Stents

Note: ccby4

---

Contributing Institute(s):

1. Demographic Studies (AG Doblhammer-Reiter)

Research Program(s):

1. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

Appears in the scientific report 2022

---

Database coverage:
; ; ; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Ebsco Academic Search ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---