Comparing 5-year Outcomes of Aorta-Coronary Bypass Surgery and Percutaneous Coronary Intervention with New-Generation Drug-Eluting Stents in Non-Diabetic and Multivessel Acute Coronary Syndrome Patients with Intermediate Syntax Score

Objectives: Our main objective was to determine the difference between patients undergoing CABG and PCI (with new-generation drug-eluting stents) who were non-diabetic during the course of a multi-vessel acute coronary syndrome (ACS) and intermediate SYNTAX score.
Methods: Between 2012 and 2014, we evaluated retrospectively 1011 non-diabetic patients with ACS in a single center. The follow-up of patients was done up to 5-years. Death associated with all causes, cardiac death, myocardial infarction, stroke, revascularization and stent thrombosis were recorded accordingly.
Results: 516 (%51) patients were included in the PCI group and 495 patients (%49) were in the CABG group. Stroke occurrence (0.8% in the PCI group and 2.6% in the CABG group, p = 0.022), repeated revascularization requirement (13.6% of the PCI group and 8.1% in the CABG group, p = 0.005) and the MACE percentage (20.3% in the PCI group, 14.5% in the CABG group, p = 0.015) were statistically significant between two groups. However, there was no statistical significance between two groups in terms of primary endpoints including death, MI, and stroke (10.9% in the PCI group and 8.3% in the CABG group, p = 0.165) and all-cause mortality (%6.2 in the PCI group, %4.7 in the CABG group, p=0.298).

Conclusion: There was no difference in all-cause mortality and myocardial infarction between the PCI and the CABG groups during a 5-year follow-up. Repeated revascularization was lower in the CABG group than the PCI group. In contrast, the stroke rates were higher in the CABG group.