17. Risk &
Benefit of CABG vs. other Therapies Over Time
Risk of CABG vs PCI vs
Medical Therapy at Two Years
Under et. al. J Thorac Cardiovasc Surg. 2003 Apr;125(4):809-20
1205 Patients randomized CABG vs PCI
At two years, there is no advantage of CABG over
At five years, there is a difference
between medical (83%), PCI (92%), and CABG (91%) survival. Dzavik
Am Heart J. 2001 Jul;142(1):119-26 But this is at five years.
Very few people will choose to risk dying today to avoid dying
five years from now. This study should integrate total days living,
not just survival at 5 years because it will take more than five
years to have the total days surviving to be improved if the first
survival advantage is at five years. Moreover, the patient is
coming for elective non-cardiac surgery. Should you be offering
a possibility of better survival five years from now when the
cost is a 3.2% 30-day mortality and 3 - 6% chance of stroke today?
Benefit of CABG vs PTCA at 5 years
Dzavik Am Heart J. 2001 Jul;142(1):119-26
Cumulative 5-year survival 11,661 patients with
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