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Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials
OBJECTIVES: To compare the safety and efficacy of percutaneous coronary intervention (PCI) using drug-eluting stent (DES) and coronary artery bypass graft (CABG) for the treatment of left main coronary artery (LMCA) disease. BACKGROUND: Several new randomized trials have recently examined the clinic...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Impact Journals LLC
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630426/ https://www.ncbi.nlm.nih.gov/pubmed/29029526 http://dx.doi.org/10.18632/oncotarget.20142 |
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author | Gao, Lei Liu, Yuqi Sun, Zhijun Wang, Yabin Cao, Feng Chen, Yundai |
author_facet | Gao, Lei Liu, Yuqi Sun, Zhijun Wang, Yabin Cao, Feng Chen, Yundai |
author_sort | Gao, Lei |
collection | PubMed |
description | OBJECTIVES: To compare the safety and efficacy of percutaneous coronary intervention (PCI) using drug-eluting stent (DES) and coronary artery bypass graft (CABG) for the treatment of left main coronary artery (LMCA) disease. BACKGROUND: Several new randomized trials have recently examined the clinical outcomes of PCI and CABG in LMCA disease. However, the results of these studies were inconsistent. MATERIALS AND METHODS: We searched five online electronic databases to identify all the randomized clinical trials assessing the outcomes of PCI using DES and CABG in patients with LMCA. The clinical outcomes were the major adverse cardiac and cerebrovascular event (MACCE), all-cause death, myocardial infarction (MI), stroke, and repeat revascularization (RR). RESULTS: A total of 5 randomized clinical trials with 4595 LMCA patients were included in this meta-analysis. For one year follow-up, the results indicated that PCI were associated with a lower risk of stroke (RR = 0.21, 95% CI = 0.07–0.65, P = 0.007), a higher risk of RR (RR = 1.72, 95% CI = 1.28–2.33, P < 0.001) than CABG. Moreover, for long-term follow-up, there were significant higher risks of MACCE and RR with PCI versus CABG (MACCE: HR = 1.26, 95% CI = 1.11–1.44, P = 0.001; RR: HR = 1.70, 95% CI = 1.42–2.05, P < 0.001). However, there were no significant differences between the two groups in all-cause death and MI risks, regardless of follow-up duration. CONCLUSIONS: PCI is noninferior to CABG in short term follow-up of patients with LMCA disease, but CABG is more safety and efficacy than PCI using DES in long-term follow-up. |
format | Online Article Text |
id | pubmed-5630426 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Impact Journals LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-56304262017-10-12 Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials Gao, Lei Liu, Yuqi Sun, Zhijun Wang, Yabin Cao, Feng Chen, Yundai Oncotarget Meta-Analysis OBJECTIVES: To compare the safety and efficacy of percutaneous coronary intervention (PCI) using drug-eluting stent (DES) and coronary artery bypass graft (CABG) for the treatment of left main coronary artery (LMCA) disease. BACKGROUND: Several new randomized trials have recently examined the clinical outcomes of PCI and CABG in LMCA disease. However, the results of these studies were inconsistent. MATERIALS AND METHODS: We searched five online electronic databases to identify all the randomized clinical trials assessing the outcomes of PCI using DES and CABG in patients with LMCA. The clinical outcomes were the major adverse cardiac and cerebrovascular event (MACCE), all-cause death, myocardial infarction (MI), stroke, and repeat revascularization (RR). RESULTS: A total of 5 randomized clinical trials with 4595 LMCA patients were included in this meta-analysis. For one year follow-up, the results indicated that PCI were associated with a lower risk of stroke (RR = 0.21, 95% CI = 0.07–0.65, P = 0.007), a higher risk of RR (RR = 1.72, 95% CI = 1.28–2.33, P < 0.001) than CABG. Moreover, for long-term follow-up, there were significant higher risks of MACCE and RR with PCI versus CABG (MACCE: HR = 1.26, 95% CI = 1.11–1.44, P = 0.001; RR: HR = 1.70, 95% CI = 1.42–2.05, P < 0.001). However, there were no significant differences between the two groups in all-cause death and MI risks, regardless of follow-up duration. CONCLUSIONS: PCI is noninferior to CABG in short term follow-up of patients with LMCA disease, but CABG is more safety and efficacy than PCI using DES in long-term follow-up. Impact Journals LLC 2017-08-10 /pmc/articles/PMC5630426/ /pubmed/29029526 http://dx.doi.org/10.18632/oncotarget.20142 Text en Copyright: © Gao et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Meta-Analysis Gao, Lei Liu, Yuqi Sun, Zhijun Wang, Yabin Cao, Feng Chen, Yundai Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
title | Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
title_full | Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
title_fullStr | Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
title_full_unstemmed | Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
title_short | Percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
title_sort | percutaneous coronary intervention using drug-eluting stents versus coronary artery bypass graft surgery in left main coronary artery disease an updated meta-analysis of randomized clinical trials |
topic | Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630426/ https://www.ncbi.nlm.nih.gov/pubmed/29029526 http://dx.doi.org/10.18632/oncotarget.20142 |
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