Cardiovascular events related to the treated coronary artery after surgical or percutaneous revascularization in patients with stable multivessel coronary artery disease: long-term comparison with medical treatment

Thiago Hueb; Edimar Alcides Bocchi; Paulo Cury Rezende; Eduardo Gomes Lima; Thiago Luis Scudeler; Paulo Rogério Soares; Fabio Antonio Venancio; Maria Stanislavovna Ta; Giovana Outuki; Izabela Jacob Martins; Ezio De Martino Neto; Carlos Vicente Serrano; Jose Antônio Franchini Ramires; Roberto Kalil Filho

doi:10.18203/2349-3259.ijct20262499

Authors

Thiago Hueb Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Edimar Alcides Bocchi Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Paulo Cury Rezende Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Eduardo Gomes Lima Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Thiago Luis Scudeler Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Paulo Rogério Soares Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Fabio Antonio Venancio Centro Universitário de Adamantina, São Paulo, Brazil
Maria Stanislavovna Ta Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Giovana Outuki Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Izabela Jacob Martins Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Ezio De Martino Neto Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Carlos Vicente Serrano Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Jose Antônio Franchini Ramires Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil
Roberto Kalil Filho Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, São Paulo, Brazil

DOI:

https://doi.org/10.18203/2349-3259.ijct20262499

Keywords:

Coronary artery disease, CABG, PCI, Cardiovascular events

Abstract

Background: Myocardial revascularization via coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is central for complex coronary artery disease (CAD). However, post-procedural adverse cardiovascular events remain challenging. Traditional efficacy assessments use composite endpoints, such as major adverse cardiovascular events (MACE), which include events unrelated to the treated artery, potentially compromising the evaluation of the intervention's true clinical impact. Objectives were to compare adverse cardiovascular events-nonfatal myocardial infarction and cardiac death-directly attributable to the artery treated by CABG or PCI, versus patients with similar CAD managed exclusively with medical therapy.

Methods: This comparative study includes patients with stable multivessel CAD undergoing CABG, PCI, or medical therapy alone. Only clinical events anatomically linked to the treated artery (or the target vessel in the medical therapy cohort) will be analyzed. This methodology aims to deliver a precise evaluation of the technical and clinical efficacy of each revascularization strategy.

Results: Data collection and statistical analysis are ongoing. The upcoming results will detail and compare the precise incidences of vessel-related myocardial infarction and cardiac death across the three therapeutic groups.

Conclusions: By prioritizing vessel-specific outcomes over traditional composite endpoints, this study addresses existing methodological limitations. It offers an accurate assessment of PCI and CABG efficacy in real-world clinical practice, aiming to guide individualized, evidence-based therapeutic decisions for stable CAD management.

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