Background: Coronary Artery Bypass Graft (CABG) is recommended for patients with left main coronary artery disease and the preferred revascularization strategy for patients with multi-vessel coronary disease, with Left Ventricular Ejection Fraction (LVEF) < 50%, and diabetes mellitus. However, recent trials are suggesting that medical therapy may prove to be as effective as interventional techniques in patients with stable coronary artery disease. This study aims to compare the outcomes of patients with stable triple vessel coronary artery disease on optimum medical therapy with or without CABG.
Method: This is a prospective cohort study wherein a total of 70 patients diagnosed with triple vessel coronary artery disease with a recommendation of CABG were enrolled in this study. Those who underwent CABG with optimal medical therapy were analyzed among the "CABG" group and those who did not undergo CABG were analyzed under the "optimal medical therapy (OMT)" group. Outcomes included assessment of the Canadian Classification Society of angina pectoris grade, occurrence of acute coronary syndrome, cerebrovascular events, congestive heart failure and all cause mortality.
Results: There were 70 patients enrolled in the study with similar baseline variables but with male preponderance. Likewise, there were similar modifiable risk factors including blood pressure, lipid profile, and HbA 1c between the two groups at baseline and at the end of study as well as similar medications except for the added use of calcium channel blockers in the OMT group. Outcomes including CCS grade for angina pectoris, occurrence of ACS, CHF, stroke and all cause mortality was similar in both group.
Conclusion: Among patients with triple vessel coronary artery disease, those who underwent CABG with OMT and those who had OMT alone did not show any difference in the occurrence of ACS, CHF, stroke, all cause mortality and CCS classification of angina pectoris.