ArticleEuropean heart journal open2026
Five-year outcomes of percutaneous coronary intervention and coronary artery bypass grafting for multivessel disease: a national population-based study of regional practice.
Article in European heart journal open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: To study how the regional preferences for less invasive multivessel coronary revascularization would adversely affect long-term clinical outcomes. Methods: A national retrospective cohort study utilizing instrumental variable analysis to estimate the causal effect of revascularization strategy.England, using national linked Hospital Episode Statistics (HES) with office of national statistic mortality data from 2007 to 2020.The analysis included 173 771 individuals with complete 5-year follow-up who underwent multivessel revascularization for coronary artery disease. Of this cohort, 63 189 (36.4%) received percutaneous coronary intervention (PCI) and 110 582 (63.6%) received coronary artery bypass grafting (CABG). In total, 37 894 (21.8%) participants were female, and 153 048 (88.2%) were of White ethnicity.The exposure was the preference between multivessel PCI or CABG. The regional ratio of CABG-to-PCI procedures was used as the instrumental variable.The primary outcome was all-cause mortality, assessed in-hospital and up to 5 years post-procedure. Results: The all-cause mortality was 2.1% ( Conclusion: Regional preferences for revascularization with multivessel PCI result in lower in-hospital all-cause mortality, a key quality metric, but worse long-term outcomes for individuals with multivessel coronary artery disease.
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