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.
- Author:
Tongwen SUN
1
;
Youdong WAN
;
Ziqi LIU
;
Shuguang ZHANG
;
Fangxia GUAN
;
Rui YAO
;
Li ZHANG
;
Ling LI
;
Jinying ZHANG
;
Quancheng KAN
2
Author Information
- Publication Type:Journal Article
- MeSH: Coronary Artery Bypass; Coronary Artery Disease; mortality; surgery; Humans; Incidence; Myocardial Infarction; Percutaneous Coronary Intervention; Randomized Controlled Trials as Topic; Stents; Treatment Outcome
- From: Chinese Journal of Cardiology 2014;42(8):693-698
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo 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).
METHODSPubMed, EMBase, 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 STATA 12.0.
RESULTSSix 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.
CONCLUSIONSThe 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.
