Abstract
Background
CABG bypass surgery with PCI revascularization procedures to date is getting advanced. These major surgeries and treatments for multivessel disorders with the inclusion of DES which is supposed to have dramatically improvised outcomes. due to insufficient prospective, randomized control trials, that reflect the recent practices, the multivessel disease optimal treatment is still uncertain. We aim to perform a specialized study that represents the evaluation of the real world that efficiently treats different (Multivessel disorders) MVDs
Methods and Results
In our study, we aim to consider 1760 patients who experience some revascularization techniques in the patients diagnosed with some MVD either in one, two, or three vessels. From these included 1760 patients, 1090 patients were suffering from 2 -2-vessel disease and the major population of 2 vessel disease underwent percutaneous coronary intervention (78 % of individuals received PCI treatment and 22% underwent CABG surgery). Out of our sample, 670 individuals were diagnosed with 3-vessel disease, it was observed that this patient group was more likely to receive CABG surgery 23 % of patients were treated with percutaneous coronary intervention, and 77 % of individuals were treated by CABG surgery. We considered many variables in our study and the major variables were target vessel failure, diseased Q-wave which was a marker for MI, death rate following one year of the procedure, and different cerebrovascular events. Multiple adverse cerebrovascular and cardiovascular events in these patients were compared between these two setups which are PCI and CABG groups. The results of these two groups were adjusted for the baseline characteristics and hazardous ratios were reported. It is proved in our study that in patients suffering from 2-vessel disease, the CABG surgery is supposed to have reduced cerebrovascular, and cardiovascular events. This comparison has a p-value of 0.02 and this reduction in CABG was 9.7% and for PCI procedure it was 21.2%, in the patients suffering from the 3-vessel disease this comparison had a p-value of 0.03 and a percentage ratio of 10.8 % to 28.4 % for CABG and PCI respectively.
Increased major adverse cerebrovascular and cardiovascular were observed from the adjusted outcomes in the 2-vessel disease patients; this had a p-value of 0.02 with a hazard ratio of 2.29 with a CL % of 95 %, and in patients suffering from the 3-vessel disease, the p-value was 0.0006 with a hazard ratio of 3.09 with a CL % of 95 %. These CAD patients were merged with diabetes mellitus. The results were adjusted for non-diabetic patients who showed multiple cardiovascular and cardio-cerebral events after the intervention of PCI revascularization for the patients suffering from the 2-vessel disease. This had a p-value of 0.002 with a hazard ratio of 3.39 with a CL % of 95 %, and for the 3-vessel disease patients, a p-value of 0.12 with a hazard ratio of 1.69 with a CL % of 95 % was observed.