Two revascularization strategies in patients with coronary heart disease and left ventricular systolic dysfunction: A systematic review and meta-analysis
10.7507/1007-4848.201712068
- VernacularTitle:两种血运重建方式对冠状动脉粥样硬化性心脏病合并左室收缩功能不全患者预后影响的系统评价与 Meta 分析
- Author:
LI Bo
1
;
WU Chunrong
2
;
FU Shiquan
1
;
CHEN Qingmei
1
;
LI Yuanjing
1
Author Information
1. Department of Cardiology, Chongqing Jiangjin Central Hospital, Chongqing, 402260, P.R.China
2. Department of Oncology, Chongqing Jiangjin Central Hospital, Chongqing, 402260, P.R.China
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass grafting;
percutaneous coronary intervention;
coronary heart disease;
left ventricular systolic dysfunction
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(2):158-164
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with coronary heart disease and left ventricular systolic dysfunction. Methods A computer-based search in PubMed, The Cochrane Library and EMbase up to October 2017, together with reference screening, was performed to identify eligible clinical trials, cohort studies and case-control studies. The outcomes of this meta-analysis included all-cause mortality, myocardial infarction, revascularization and stroke, and the effect sizes for them were presented as relative risk (RR) with its 95% confidence intervals (CI). Results Fifteen cohort studies and 2 randomized controlled trials were finally included with a total of 11 985 patients, of whom 6 322 were in the CABG group and 5 663 in the PCI group. The result of meta-analysis showed that all-cause mortality was significantly lower in the CABG group than that in the PCI group (18.6% vs. 23.0%, RR=0.87, 95% CI 0.81 to 0.94, P<0.001). In addition, CABG was associated with a remarkably reduced risk of revascularization (RR=0.28, 95% CI 0.19 to 0.42, P<0.001) compared with PCI, with no significant difference in incidence of myocardial infarction (RR=0.78, 95% CI 0.47 to 1.32, P=0.36) and stroke (RR=1.28, 95% CI 0.89 to 1.86, P=0.18). Conclusion CABG is superior to PCI in the treatment for patients with coronary heart disease and left ventricular systolic dysfunction. Owing to the limited quality of included studies, additional large, randomized controlled trails are still required to confirm this finding.
