Why the study?
Do goal achievement rates of cardiovascular risk factors differ between patients treated with PCI versus CABG?
Cohort
No
Do goal achievement rates of cardiovascular risk factors differ between patients treated with PCI versus CABG?
Patients undergoing PCI are more likely to achieve secondary prevention goals for LDL-C and blood pressure compared to those undergoing CABG, highlighting a disparity in risk factor management.
Answers are grounded in this paper and cite their sources.
Higher LDL-C goal rates after PCI versus CABG should not change practice; leaves open whether revascularization strategy affects secondary prevention.
BACKGROUND: Data are scarce regarding disparities in cardiovascular risk factor management between patients treated with percutaneous coronary intervention (PCI) and those treated with coronary artery bypass grafting (CABG). OBJECTIVE: Whether the goal achievement rates of cardiovascular risk factors were different between PCI and CABG patients. METHODS: We retrospectively reviewed the data retrieved from a clinical record database of patients admitted to Beijing Anzhen Hospital between January 1, 2014, and December 31, 2014, who underwent PCI or CABG. RESULTS: Compared with the CABG group, low-density lipoprotein cholesterol (LDL-C) < 1.8 mmol/L (28.6% vs. 24.7%; p < 0.01), LDL-C < 2.07 mmol/L (43.5% vs. 39.4%; p < 0.01) and blood pressure (BP) < 140/90 mm Hg (85.6% vs. 77.7%; p < 0.01) goal achievement rates were significantly higher in the PCI group. Compared with patients ≥ 60 years old: patients < 60 years old had better BP < 140/90 mm Hg goal achievement rates (87.7% vs. 84.4%; p < 0.01) in the PCI group, and better fasting blood-glucose (FBG) < 7 mmol/L (79.4% vs.72.0%; p < 0.01) and HbA1c < 7% (79.4% vs. 70.1%; p < 0.01) goal achievement rates in the CABG group. Compared with females: males had better LDL-C < 2.07 mmol/L (24.7% vs. 28.5%; p < 0.01), FBG < 7 mmol/L (71.8% vs.75.2%; p < 0.01) and HbA1c < 7% (70.4% vs. 74.1%; p < 0.01) goal achievement rates in the PCI group. CONCLUSION: Patients in the PCI group were generally more likely than those in the CABG group to achieve LDL-C < 1.8 mmol/L and BP goals. The control of cardiovascular risk factors differed between patients ≥ 60 years old and < 60 years old. Female patients were less likely to achieve LDL-C, FBG and HbA1c goals.
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Gao et al. (2017) conducted a cohort in Coronary artery disease requiring revascularization. Percutaneous coronary intervention (PCI) vs. Coronary artery bypass grafting (CABG) was evaluated on Goal achievement rate for LDL-C < 1.8 mmol/L (p=< 0.01).
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