Safety and effectiveness of drug-eluting stent versus coronary artery bypass grafting for left anterior descending coronary artery stenosis: a systematic review
10.7644/j.issn.1674-9960.2017.06.026
- VernacularTitle:药物洗脱支架与冠状动脉旁路移植术治疗冠状动脉左前降支狭窄安全性和疗效比较的系统评价
- Author:
Liang HOU
;
Laibo YIN
;
Jialong ZHU
;
Zhijun ZHU
;
Siyuan HU
- Keywords:
coronary heart disease;
drug eluting stent;
coronary artery bypass grafting;
left anterior descending coronary disease;
meta-analysis;
systematic review
- From:Military Medical Sciences
2017;41(6):524-529
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the efficacy and safety of drug-eluting stent(DES) versus coronary artery bypass grafting(CABG) in the treatment of left anterior descending coronary artery(CAD) stenosis.Methods Literature about the efficacy and safety of DES versus CABG for LAD stenosis was retrieved from digital databases of MEDLINE, EMbase, PubMed, and the Cochrane Library by November 2016.Data extraction and quality assessment of included studies were conducted by two independent reviewers.RevMan 5.3 software was used to perform meta-analysis.Results Ten studies involving 9771 patients were finally included.The results of meta-analysis showed that there was no significant difference in mortality [RR=0.88,95%CI(0.70,1.11),P=0.28],major adverse cardiovascular events[MACE,RR=1.04,95%CI(0.88,1.24),P=0.63] or myocardial infarction [MI,RR=0.92,95%CI(0.56,1.53),P=0.75], but PCI-DES significantly increased the risk of TVR [OR=2.43,95%CI(1.61,3.69),P<0.0001].Conclusion For LAD stenosis, PCI-DES strategy causes as high a rate of mortality, MACE and MI as CABG or DES, but PCI-DES can significantly increase the risk of TVR, so we should be cautious clinically.
