TY - JOUR
T1 - Meta-analysis of long-term outcomes of percutaneous coronary intervention or coronary artery bypass graft surgery in coronary artery disease patients with multi-vessel and/or left main stem disease
AU - Sun, Tongwen
AU - Wan, Youdong
AU - Liu, Ziqi
AU - Zhang, Shuguang
AU - Guan, Fangxia
AU - Yao, Rui
AU - Zhang, Li
AU - Li, Ling
AU - Zhang, Jinying
AU - Kan, Quancheng
PY - 2014/8/24
Y1 - 2014/8/24
N2 - Objective: To evaluate the long-term outcomes of coronary artery disease patients with left main stem and/or multi-vessel disease receiving percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG).Methods: PubMed, EM Base, Cochrane central register of controlled trials were searched to identify randomized controlled trials concerning the long-term outcomes of PCI and CABG in coronary artery disease patients with left main stem and/or multi-vessel disease before May 2013. Keywords included "angioplasty", "coronary", "coronary artery bypass surgery" and "stent". The data were analyzed by ST ATA 12.0.Results: Six randomized controlled trials (5 071 patients) were enrolled for analyses. Five years all-cause mortality (RR = 1.13, 95% CI-.0. 88-1. 44, P =0. 35), incidence of myocardial infarction (RR= 1.20, 95%CI:0. 69-2. 07, P = 0. 53), and angina (RR = 1. 17,95% CI:0. 88-1. 57, P=0. 28) were similar between PCI and CABG groups. Major adverse cardiac and cerebrovascular event (RR = 1. 85, 95% CI-. 1. 38-2. 48, P < 0. 01) and repeat revascularization (RR = 3. 48, 95% CI: 2. 20-5. 53, P < 0. 01) were significantly higher in PCI compared to CABG.Conclusions: The present analysis suggests that 5 years all-cause mortality is similar between PCI and CABG strategies. However, PCI is associated with higher major adverse cardiac and cerebrovascular event and repeat revascularization rate compared to CABG in patients with unprotected left main stem and/or multi-vessel disease.
AB - Objective: To evaluate the long-term outcomes of coronary artery disease patients with left main stem and/or multi-vessel disease receiving percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG).Methods: PubMed, EM Base, Cochrane central register of controlled trials were searched to identify randomized controlled trials concerning the long-term outcomes of PCI and CABG in coronary artery disease patients with left main stem and/or multi-vessel disease before May 2013. Keywords included "angioplasty", "coronary", "coronary artery bypass surgery" and "stent". The data were analyzed by ST ATA 12.0.Results: Six randomized controlled trials (5 071 patients) were enrolled for analyses. Five years all-cause mortality (RR = 1.13, 95% CI-.0. 88-1. 44, P =0. 35), incidence of myocardial infarction (RR= 1.20, 95%CI:0. 69-2. 07, P = 0. 53), and angina (RR = 1. 17,95% CI:0. 88-1. 57, P=0. 28) were similar between PCI and CABG groups. Major adverse cardiac and cerebrovascular event (RR = 1. 85, 95% CI-. 1. 38-2. 48, P < 0. 01) and repeat revascularization (RR = 3. 48, 95% CI: 2. 20-5. 53, P < 0. 01) were significantly higher in PCI compared to CABG.Conclusions: The present analysis suggests that 5 years all-cause mortality is similar between PCI and CABG strategies. However, PCI is associated with higher major adverse cardiac and cerebrovascular event and repeat revascularization rate compared to CABG in patients with unprotected left main stem and/or multi-vessel disease.
KW - Angioplasty transluminal percutaneous coronary
KW - Cardiac surgical procedures
KW - Meta-analysis
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U2 - 10.3760/cma.j.issn.0253-3758.2014.08.016
DO - 10.3760/cma.j.issn.0253-3758.2014.08.016
M3 - Article
C2 - 25388345
AN - SCOPUS:84920386859
SN - 0253-3758
VL - 42
SP - 693
EP - 698
JO - Chinese Journal of Cardiology
JF - Chinese Journal of Cardiology
IS - 8
ER -