EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology | 2019
Major Infections after Bypass Surgery and Stenting for Multivessel Coronary Disease: An analysis of the randomized SYNTAX trial.
Abstract
AIMS\nIncidence, associated risk factors and impact on mortality of infections after bypass surgery (CABG) and stenting (PCI) for multivessel coronary disease (MVD) have never been reported in a large randomized trial. The aim of the present study is to evaluate, in patients with MVD, the prevalence of major infections after PCI and CABG and assess their impact on mortality.\n\n\nMETHODS AND RESULTS\nThe SYNTAX trial randomized 1800 MVD patients to either CABG or PCI. Patients were followed up to 5 years. The primary endpoint of this post-hoc analysis was the occurrence of major infection. At 5 years of follow-up, the primary endpoint occurred in 142 (15.8%) patients in the CABG arm and 44 (4.9%) patients in the PCI arm (≤ 60 days- HR 7.9, 95% CI 4.7 to 13.1; p<0.001) (> 60 days- HR 0.79, 95% CI 0.44 to 1.44; p=0.45). Major infections were independently associated with a higher risk of all-cause mortality at 5 years (adjusted HR 2.6, 95% CI 1.8 to 3.8, p<0.001).\n\n\nCONCLUSIONS\nCABG is associated with a higher incidence of post-procedure major infections compared to PCI. Major infections are independently associated with all-cause mortality.