Journal Article

Long Time No See! Revisiting Single-Vessel Revascularization: Importance of Robust Study Design and Database Utilization

Nienaber, Christoph A., Nienaber, Stephan

2024

Overview

[...]what is the motivation for such a study, loaded with methodological shortcomings, resulting in misleading information considering that extraction of data from NIS is unlikely to be a reliable source of information, as NIS exclusively documents in-patients? [...]both single-vessel intervention groups comprise patients with left main coronary artery disease, but while a percutaneous strategy would indeed address a single vessel (the left main stem), the surgical strategy would require at least two bypasses or more. [...]the mortality figures for both procedures, i.e., 2.7% for single-vessel PCI and 2.8% for single-vessel coronary artery bypass grafting (CABG) (both in the pre-propensity-matched sample as well as in the propensity-matched sample), are astonishingly high, adding to the confusion and suggesting that a high number of patients were treated in the acute setting of evolving myocardial infarction, or under other critical conditions for which an open-heart surgical bypass constitutes a well-known risk higher than that of any percutaneous revascularization strategy [2,7]. [...]relevant conclusions can only be derived from good data generated from properly designed studies or granular prospective registries.

• Publisher: MDPI AG
• Subject: Cardiovascular disease / Coronary vessels / Heart surgery / Intervention / Mortality / n/a / Vein & artery diseases