Long Term outcomes of Contemporary Coronary Revascularization by PCI or CABG in Young Adults

Introduction: Current guidelines for choosing between revascularization modality may not be appropriate for young patients. We aimed to compare outcomes in our patients aged 8-2018 in order to better guide treatment in this group of patients.

Metirials and Methods: We compared outcomes of 183 consecutive patients aged

Results and disscusion: The mean age was 36.3 years, 96% were male. Risk factors were similar for both groups. Drug eluting stents were used in 71% of PCI patients and total arterial revascularization in 74% of CABG patients. During a median follow up of 6.5 years, 16 (8.6%) patients died. There were 35 (38.8%) first cardiovascular events in the PCI group vs. 29 (31.1%) in the CABG group (log rank p=0.022); and 96 vs. 51 (P<0.01) repeat events occurred. After multivariate adjustment, CABG was associated with a significantly reduced risk for first adverse event (hazard ratio (HR)=0.305, P<0.01), driven solely by reduction in repeat revascularization. CABG was also associated with a reduction in overall repeat events (HR=0.293, P<0.01). There was no difference in overall mortality between CABG and PCI.

Conclusions: in our cohort of young patients with coronary disease, those treated with CABG showed a reduction in the risk for nonfatal cardiac events. Mortality was similar with either modality.