Abstract:Objective To compare the effectiveness of drug-eluting stent implantation(DES-PCI) and off-pump coronary artery bypass grafting(OPCAB) for coronary artery disease patients with three-vessel disease(TVD). Methods A retrospective analysis of consecutive patients with TVD undergoing DES-PCI or OPCAB between January 2017 and June 2018 was carried out.According to different revascularization methods,they were divided into DES-PCI group and OPCAB group.The patients were followed up for 2 years to observe the incidence of all-cause death,revascularization,non fatal myocardial infarction(MI),stroke and major adverse cardiac and cerebrovascular events (MACCE). Results A total of 688 patients were identified:435 cases of DES-PCI and 253 cases of OPCAB.Compared with OPCAB group after 1-year follow-up,the rate of revascularization increased in DES-PCI group (3.68% vs 0.40%,P<0.01).Compare with OPCAB group during 2-year follow-up,there were significant rise in the repeat revascularization rate(11.72% vs 1.58%,P<0.01),the non-fatal MI rate(4.14% vs 1.19%,P<0.05) and the incidence rate of MACCE(22.30% vs 13.83%,P<0.01),but significant reduction in stroke rate(2.07% vs 4.74%,P<0.05).There was no significant difference in all-cause mortality between the two groups(1.61% vs 3.16%,P>0.05). Conclusions For TVD patients,OPCAB is superior to DES-PCI in reducing revascularization,non fatal MI and MACCE.However,the incidence of stroke in OPCAB group is higher,which still meeds a longer-term follow-up study.