Coronary artery bypass grafting (CABG) after initially successful percutaneous transluminal coronary angioplasty (PTCA): a review of 17 years experience
Objective: Patients who undergo successful percutaneous transluminal coronary angioplasty (PTCA) may subsequently require operative myocardial revascularization. This review examines whether prior successful PTCA alters outcomes following subsequent coronary artery bypass grafting (CABG). The costs...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2003-02, Vol.23 (2), p.179-186 |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Barakate, M.S. Hemli, J.M. Hughes, C.F. Bannon, P.G. Horton, M.D. |
| description | Objective: Patients who undergo successful percutaneous transluminal coronary angioplasty (PTCA) may subsequently require operative myocardial revascularization. This review examines whether prior successful PTCA alters outcomes following subsequent coronary artery bypass grafting (CABG). The costs of interventional cardiology procedures and definitive surgery were also examined. Methods: From January 1981 through December 1997, 361 patients underwent CABG following initially successful PTCA (interval group). This group was compared with 11 909 patients who underwent CABG as the primary intervention for coronary artery disease (control group). Results: The average time interval to CABG following initial PTCA was 13.7 months. The post-CABG myocardial infarction rate was 4% for patients in the interval group and 3% for patients in the control group. The 30-day mortality was similar for both patient groups (2%). For the interval group, the average cost of total interventional management was $24 220 per patient. This included average costs of $13 873 for CABG and $10 347 for all preoperative interventional cardiology procedures. Conclusion: There is little doubt that PTCA procedures may provide successful myocardial revascularization. However, these procedures often need to be repeated over time and may serve only to delay coronary surgery, at substantial financial and personal cost. |
| doi_str_mv | 10.1016/S1010-7940(02)00764-9 |
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This review examines whether prior successful PTCA alters outcomes following subsequent coronary artery bypass grafting (CABG). The costs of interventional cardiology procedures and definitive surgery were also examined. Methods: From January 1981 through December 1997, 361 patients underwent CABG following initially successful PTCA (interval group). This group was compared with 11 909 patients who underwent CABG as the primary intervention for coronary artery disease (control group). Results: The average time interval to CABG following initial PTCA was 13.7 months. The post-CABG myocardial infarction rate was 4% for patients in the interval group and 3% for patients in the control group. The 30-day mortality was similar for both patient groups (2%). For the interval group, the average cost of total interventional management was $24 220 per patient. This included average costs of $13 873 for CABG and $10 347 for all preoperative interventional cardiology procedures. Conclusion: There is little doubt that PTCA procedures may provide successful myocardial revascularization. However, these procedures often need to be repeated over time and may serve only to delay coronary surgery, at substantial financial and personal cost.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/S1010-7940(02)00764-9</identifier><identifier>PMID: 12559340</identifier><identifier>CODEN: EJCSE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Science B.V</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - economics ; Angioplasty, Balloon, Coronary - mortality ; Biological and medical sciences ; Chi-Square Distribution ; Coronary Angiography - economics ; Coronary Artery Bypass - adverse effects ; Coronary Artery Bypass - economics ; Coronary Artery Bypass - mortality ; Coronary artery bypass grafting ; Coronary Disease - surgery ; Coronary Disease - therapy ; Costs and Cost Analysis ; Female ; Follow-Up Studies ; Humans ; Interval ; Male ; Medical sciences ; Middle Aged ; Odds Ratio ; Patient Selection ; Percutaneous transluminal coronary angioplasty ; Postoperative Complications ; Prospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Treatment Outcome ; Tropical medicine</subject><ispartof>European journal of cardio-thoracic surgery, 2003-02, Vol.23 (2), p.179-186</ispartof><rights>Elsevier Science B.V. © 2002 Elsevier Science B.V. 2002</rights><rights>2003 INIST-CNRS</rights><rights>Copyright 2002 Elsevier Science B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c496t-c115c4528e934475073dbe0aeb3f619fea2e21f8af35c0df9cb5f71364586a263</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14490463$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12559340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barakate, M.S.</creatorcontrib><creatorcontrib>Hemli, J.M.</creatorcontrib><creatorcontrib>Hughes, C.F.</creatorcontrib><creatorcontrib>Bannon, P.G.</creatorcontrib><creatorcontrib>Horton, M.D.</creatorcontrib><title>Coronary artery bypass grafting (CABG) after initially successful percutaneous transluminal coronary angioplasty (PTCA): a review of 17 years experience</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><addtitle>Eur J Cardiothorac Surg</addtitle><description>Objective: Patients who undergo successful percutaneous transluminal coronary angioplasty (PTCA) may subsequently require operative myocardial revascularization. This review examines whether prior successful PTCA alters outcomes following subsequent coronary artery bypass grafting (CABG). The costs of interventional cardiology procedures and definitive surgery were also examined. Methods: From January 1981 through December 1997, 361 patients underwent CABG following initially successful PTCA (interval group). This group was compared with 11 909 patients who underwent CABG as the primary intervention for coronary artery disease (control group). Results: The average time interval to CABG following initial PTCA was 13.7 months. The post-CABG myocardial infarction rate was 4% for patients in the interval group and 3% for patients in the control group. The 30-day mortality was similar for both patient groups (2%). For the interval group, the average cost of total interventional management was $24 220 per patient. This included average costs of $13 873 for CABG and $10 347 for all preoperative interventional cardiology procedures. Conclusion: There is little doubt that PTCA procedures may provide successful myocardial revascularization. However, these procedures often need to be repeated over time and may serve only to delay coronary surgery, at substantial financial and personal cost.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Angioplasty, Balloon, Coronary - economics</subject><subject>Angioplasty, Balloon, Coronary - mortality</subject><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>Coronary Angiography - economics</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Bypass - economics</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Coronary artery bypass grafting</subject><subject>Coronary Disease - surgery</subject><subject>Coronary Disease - therapy</subject><subject>Costs and Cost Analysis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Interval</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Patient Selection</subject><subject>Percutaneous transluminal coronary angioplasty</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Treatment Outcome</subject><subject>Tropical medicine</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkd1u1DAQhSMEoqXwCCDfgHYvAv6NY-6WAC3SCiq1oIoby_GOV4ZsEuwEmjfhcfE2Syskbjwe6TtzNHOy7CnBLwkmxauL9OJcKo4XmC4xlgXP1b3smJSS5ZLxq_vp_xc5yh7F-A1jXDAqH2ZHhAqhGMfH2e-qC11rwoRMGCCVeupNjGgbjBt8u0WLavXmdIlSBwH51g_eNM2E4mgtxOjGBvUQ7DiYFroxoiGYNjbjzremQfZ2drv1Xd-YOExocX5ZrZavkUEBfnr4hTqHiEQTmBARXKdpHloLj7MHzjQRnhzqSfb5_bvL6ixffzr9UK3WueWqGHJLiLBc0BLSPlwKLNmmBmygZq4gyoGhQIkrjWPC4o1TthZOElZwURaGFuwkezHP7UP3Y4Q46J2PFppmXkhLqhSmJUmgmEEbuhgDON0Hv0vbaYL1PhJ9E4ne31tjqm8i0Srpnh0MxnoHmzvVIYMEPD8AJlrTuHRB6-Mdx7nCvGCJwzPXjf3_vfN_vPO9dz5LfBzg-lZkwnddSCaFPrv6qss1kx_fnl_oL-wP2i-zMQ</recordid><startdate>20030201</startdate><enddate>20030201</enddate><creator>Barakate, M.S.</creator><creator>Hemli, J.M.</creator><creator>Hughes, C.F.</creator><creator>Bannon, P.G.</creator><creator>Horton, M.D.</creator><general>Elsevier Science B.V</general><general>Elsevier Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030201</creationdate><title>Coronary artery bypass grafting (CABG) after initially successful percutaneous transluminal coronary angioplasty (PTCA): a review of 17 years experience</title><author>Barakate, M.S. ; Hemli, J.M. ; Hughes, C.F. ; Bannon, P.G. ; Horton, M.D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c496t-c115c4528e934475073dbe0aeb3f619fea2e21f8af35c0df9cb5f71364586a263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Angioplasty, Balloon, Coronary - economics</topic><topic>Angioplasty, Balloon, Coronary - mortality</topic><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>Coronary Angiography - economics</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary Artery Bypass - economics</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Coronary artery bypass grafting</topic><topic>Coronary Disease - surgery</topic><topic>Coronary Disease - therapy</topic><topic>Costs and Cost Analysis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Interval</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Patient Selection</topic><topic>Percutaneous transluminal coronary angioplasty</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Treatment Outcome</topic><topic>Tropical medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barakate, M.S.</creatorcontrib><creatorcontrib>Hemli, J.M.</creatorcontrib><creatorcontrib>Hughes, C.F.</creatorcontrib><creatorcontrib>Bannon, P.G.</creatorcontrib><creatorcontrib>Horton, M.D.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barakate, M.S.</au><au>Hemli, J.M.</au><au>Hughes, C.F.</au><au>Bannon, P.G.</au><au>Horton, M.D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary artery bypass grafting (CABG) after initially successful percutaneous transluminal coronary angioplasty (PTCA): a review of 17 years experience</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><stitle>Eur J Cardiothorac Surg</stitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2003-02-01</date><risdate>2003</risdate><volume>23</volume><issue>2</issue><spage>179</spage><epage>186</epage><pages>179-186</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><coden>EJCSE7</coden><abstract>Objective: Patients who undergo successful percutaneous transluminal coronary angioplasty (PTCA) may subsequently require operative myocardial revascularization. This review examines whether prior successful PTCA alters outcomes following subsequent coronary artery bypass grafting (CABG). The costs of interventional cardiology procedures and definitive surgery were also examined. Methods: From January 1981 through December 1997, 361 patients underwent CABG following initially successful PTCA (interval group). This group was compared with 11 909 patients who underwent CABG as the primary intervention for coronary artery disease (control group). Results: The average time interval to CABG following initial PTCA was 13.7 months. The post-CABG myocardial infarction rate was 4% for patients in the interval group and 3% for patients in the control group. The 30-day mortality was similar for both patient groups (2%). For the interval group, the average cost of total interventional management was $24 220 per patient. This included average costs of $13 873 for CABG and $10 347 for all preoperative interventional cardiology procedures. Conclusion: There is little doubt that PTCA procedures may provide successful myocardial revascularization. However, these procedures often need to be repeated over time and may serve only to delay coronary surgery, at substantial financial and personal cost.</abstract><cop>Amsterdam</cop><pub>Elsevier Science B.V</pub><pmid>12559340</pmid><doi>10.1016/S1010-7940(02)00764-9</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult Aged Aged, 80 and over Angioplasty, Balloon, Coronary - adverse effects Angioplasty, Balloon, Coronary - economics Angioplasty, Balloon, Coronary - mortality Biological and medical sciences Chi-Square Distribution Coronary Angiography - economics Coronary Artery Bypass - adverse effects Coronary Artery Bypass - economics Coronary Artery Bypass - mortality Coronary artery bypass grafting Coronary Disease - surgery Coronary Disease - therapy Costs and Cost Analysis Female Follow-Up Studies Humans Interval Male Medical sciences Middle Aged Odds Ratio Patient Selection Percutaneous transluminal coronary angioplasty Postoperative Complications Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Treatment Outcome Tropical medicine |
| title | Coronary artery bypass grafting (CABG) after initially successful percutaneous transluminal coronary angioplasty (PTCA): a review of 17 years experience |
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