• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Patient age & benefit of PCI vs CABG: PCI better outcomes for younger patients, CABG better outcomes for older patients

bys25qthea
November 29, 2012
in Cardiology, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD/NIH

PCI =  Percutaneous Intervention, CABG: Coronary Artery Bypass Graft 

Key study points:

1. A pooled analysis of 10 clinical trials with 7,812 patients showed a shift in the comparative effectiveness of CABG versus PCI with age.

2. Older patients experienced lower rates of mortality and a composite of death and myocardial infarction with CABG, whereas younger patients fared better with PCI.

Primer: In patients with multivessel coronary artery disease, the decision between percutaneous intervention (PCI) versus open cardiac surgery (CABG) can be challenging, with extent of disease, vascular complexity, comorbidities, and ability to tolerate surgery all under consideration, often pointing in opposing therapeutic directions.

RELATED REPORTS

Sodium-glucose cotransporter 2 inhibitors may decrease risk of serious liver events in patients with cirrhosis

#VisualAbstract: Lactated Ringer’s Solution Does Not Improve Outcomes Relative to Normal Saline

2MM: AI Roundup – FDA’s AI Push, Trial Speedups with Real-World Data, Smart Surgical Monitors, and Regulatory Overhaul Begins [July 2nd, 2025]

Overall, studies to date show similar mortality rates between PCI and CABG. However, this study found significant differences when results were stratified by age: pooling outcomes from 10 randomized trials with regards to patient age demonstrated a decreasing risk of major cardiac events in CABG compared to PCI as patients got older. This difference by age persisted among the subgroup of patients with diabetes, and with both metal stents and balloon angioplasty.

This [retrospective] study: 10 randomized trials comparing CABG and PCI in patients with multivessel disease were pooled, with age analyzed as a continuous variable for a primary outcome of all-cause mortality and secondary outcomes of a composite of death or myocardial infarction, need for repeat revascularization, and angina at 1 year. Overall, these 10 trials found no difference in mortality rates between PCI and CABG. When the patient population was stratified by age, however, CABG to PCI hazard ratios were 1.23 for the youngest group of <56.2 years, 0.89 for the middle group 56.3 to 65.1 years, and 0.79 for the oldest group. The interaction on age with the relative risk over data points had a P<0.01. Rates of angina after 1 year and repeat vascularization were reduced to a similar extent by CABG compared to PCI in all age groups; there was no differential effect by age.

In sum: The relative risk of PCI is higher in older patients whereas the relative risk of CABG is higher in younger patients. Of note, given the low number of patients over 75 years of age, the study was not appropriately powered to assess risk in the oldest of patients. There were also many secondary variables that were not included in the study (extent of disease, renal function, anemic, etc.) and therefore cannot be excluded as potential confounders. Finally, the study did not include the most recent PCI trials that utilized drug-eluting stents. Upon review of the literature, the study authors did not believe that inclusion of drug-eluting stents would change the increasing risk of PCI with age, but additional studies would be needed to confirm.

Click to read the article in the Journal of the American College of Cardiology

More from this author: CABG demonstrates better rates of survival versus PCI in diabetic patients: FREEDOM trial, Modifying mitral valve structure concurrently with coronary bypass helps post-MI patients optimize cardiac function and improve functional status

By [GS] and [AH]

© 2012 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.  

Previous Post

Three months of antibiotics appear to effectively treat early-onset spinal implant infections

Next Post

ADHD medication decreases rates of criminality in ADHD patients

RelatedReports

Low free sugar diet reduces hepatic steatosis in nonalcoholic fatty liver disease in adolescent males
Chronic Disease

Sodium-glucose cotransporter 2 inhibitors may decrease risk of serious liver events in patients with cirrhosis

July 2, 2025
#VisualAbstract: Lactated Ringer’s Solution Does Not Improve Outcomes Relative to Normal Saline
StudyGraphics

#VisualAbstract: Lactated Ringer’s Solution Does Not Improve Outcomes Relative to Normal Saline

July 2, 2025
2MM: AI Roundup- AI Cancer Test, Smarter Hospitals, Faster Drug Discovery, and Mental Health Tech [May 2nd, 2025]
AI Roundup

2MM: AI Roundup – FDA’s AI Push, Trial Speedups with Real-World Data, Smart Surgical Monitors, and Regulatory Overhaul Begins [July 2nd, 2025]

July 2, 2025
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Celebrity diagnoses spur screenings, athlete mental-health push, reality-TV heart lesson, and a sitcom PSA wave

July 2, 2025
Next Post

ADHD medication decreases rates of criminality in ADHD patients

Pediatric patients not receiving quality palliative care despite agreement between parents and caregivers on valued elements of care

Patients who utilize online health services make greater use of in-person services

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Sodium-glucose cotransporter 2 inhibitors may decrease risk of serious liver events in patients with cirrhosis
  • #VisualAbstract: Lactated Ringer’s Solution Does Not Improve Outcomes Relative to Normal Saline
  • 2MM: AI Roundup – FDA’s AI Push, Trial Speedups with Real-World Data, Smart Surgical Monitors, and Regulatory Overhaul Begins [July 2nd, 2025]
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.