Abstract
The aim of the present study was to investigate major cardiac events and the similarities and differences of medical costs among patients with multivessel complex coronary artery disease (MCCAD) during the three-year follow-up. The MCCAD patients had undergone single complete revascularization (CR), fractionated revascularization (FR) or partial revascularization (PR) and the present study aimed to screen the optimal treatment program. A total of 2,309 MCCAD patients who had been treated at a single center in the last decade, among which 1,020 cases underwent single CR, 856 cases successively underwent FR and 433 cases only underwent PR, were followed-up for three years. Major cardiac events, including all-cause mortality, myocardial infarction, severe heart failure, rehospitalization and revascularization (coronary artery bypass grafting and coronary stent reimplantation), were set as the end points. In addition, the three-year medical costs associated with heart disease were analyzed. The three-year cardiac event rate in the CR group (17%) was significantly lower compared with the other two groups and the average three-year medical costs in the CR group (62,100 RMB) were significantly lower than those in the other two groups. Therefore, under permissive conditions, single CR is the optimal and most economical treatment strategy for patients with MCCAD.
Highlights
With the increasing incidence of coronary artery disease (CAD), coronary angiography, as the gold standard for CAD diagnosis, has obtained growing popularity
multivessel complex coronary artery disease (MCCAD) is one of the most serious types of CAD that commonly leads to complications, including heart enlargement, heart failure, malignant arrhythmias and cardiac sudden death, which seriously impacts the quality of life and life expectancy of a patient
The results revealed that throughout the follow‐up period, the rates of recurrent angina, nonfatal myocardial infarction, heart failure, rehospitalization due to the aforementioned reasons and revascularization in the partial revascularization (PR) group were statistically significantly higher than those in the complete revascularization (CR) group, indicating that the short and long‐term prognoses of CR were better compared with those of PR
Summary
With the increasing incidence of coronary artery disease (CAD), coronary angiography, as the gold standard for CAD diagnosis, has obtained growing popularity. It has been identified that multivessel lesions are common in stable angina and acute coronary syndrome [1,2], Key words: multivessel coronary artery disease, complete revascularization, incomplete revascularization, prognosis and are an independent predictor of CAD that affects the prognosis of patients [3]. Controversy remains with regard to the treatment strategies for patients with multivessel complex coronary artery disease (MCCAD), in recent years. Since the one‐step implantation of multi‐stents has been charged and limited, it remains inconclusive whether patients with MCCAD should undergo single complete revascularization (CR), fractionated revascularization (FR) or partial revascularization (PR). The present retrospective study compared the effects of the various revascularization modes (complete, fractionated or partial) with regard to the long‐term prognosis of patients with MCCAD.
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