Comparison of coronary artery bypass grafting and percutaneous coronary intervention for syphilitic coronary artery ostial lesions: A 4-year retrospective study

• Published in: Medicine (Baltimore) 2020-05, Vol.99 (21), p.e20104-e20104
• Main Authors: Han, Junyu, Zheng, Wuyang, Li, Weihua, Xie, Qiang, Huang, Zhengrong, Yang, Shuyu
• Format: Article
• Language: English
• Subjects: Adult; Coronary Artery Bypass - methods; Coronary Artery Disease - surgery; Female; Humans; Male; Middle Aged; Observational Study; Percutaneous Coronary Intervention - methods; Retrospective Studies; Syphilis, Cardiovascular - surgery; Treatment Outcome
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000020104

This study investigated the efficacy of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in treatment of patients with syphilitic coronary artery ostial lesions (SCAOL).Sixty SCAOL patients were divided into two groups according to the different treatments: the CABG group (n = 32) and the PCI group (n = 28). We determined serum levels of β-type natriuretic peptide (BNP) and cardiac function, and evaluated treatment efficacy such as the rates of restenosis, patency, and major adverse cardiovascular events (MACEs) during hospital stay and the effects of antisyphilis and different types of CABG on restenosis during the 6-month follow-up period.There were no statistical differences in demographic or baseline clinical characteristics, BNP levels, left ventricular end-diastolic diameter (LVDd), or ejection fraction (EF) between the CABG and PCI groups at 1 week after surgery, However, after 6-month of follow-up, the CABG group had a significantly lower rate of coronary artery restenosis, lower incidence of MACEs, and better cardiac function than the PCI group. Within the CABG group, the left internal mammary artery (LIMA) subgroup had a lower restenosis rate than the saphenous vein graft (SVG) subgroup. In addition, patients who had received anti-syphilis therapy had a significantly lower restenosis rate than those without anti-syphilis therapy at 6-month post-surgery.Compared with patients who received PCI, patients who received CABG had better prognoses. LIMA has a better therapeutic efficacy than SVG in terms of the restenosis rate, and anti-syphilis treatment significantly reduces the restenosis rate, compared with non-anti-syphilis treatment.