Cargando…
Prior percutaneous coronary intervention and outcomes in patients after coronary artery bypass grafting: a meta-analysis of 308,284 patients
BACKGROUND: The association between prior percutaneous coronary intervention (PCI) and prognosis after coronary artery bypass grafting (CABG) remains uncertain. We aimed to evaluate the aforementioned association in a meta-analysis. METHODS: PubMed, Cochrane’s Library, and Embase databases were sear...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109498/ https://www.ncbi.nlm.nih.gov/pubmed/35586304 http://dx.doi.org/10.1177/20406223221078755 |
_version_ | 1784708912797188096 |
---|---|
author | Zhang, Hongliang Zhao, Zhenyan Yao, Jing Zhao, Jie Hou, Tao Wang, Moyang Xu, Yanlu Wang, Bincheng Niu, Guannan Sui, Yonggang Song, Guangyuan Wu, Yongjian |
author_facet | Zhang, Hongliang Zhao, Zhenyan Yao, Jing Zhao, Jie Hou, Tao Wang, Moyang Xu, Yanlu Wang, Bincheng Niu, Guannan Sui, Yonggang Song, Guangyuan Wu, Yongjian |
author_sort | Zhang, Hongliang |
collection | PubMed |
description | BACKGROUND: The association between prior percutaneous coronary intervention (PCI) and prognosis after coronary artery bypass grafting (CABG) remains uncertain. We aimed to evaluate the aforementioned association in a meta-analysis. METHODS: PubMed, Cochrane’s Library, and Embase databases were searched for potential studies. A random-effects model was used for the meta-analysis. Meta-regression was performed to evaluate the influence of study characteristics on the outcomes. RESULTS: Thirty-six follow-up studies with 308,284 patients were included, and 40,892 (13.3%) patients had prior PCI. Pooled results showed that prior PCI was associated with higher risks of early (in-hospital or within 1 month) all-cause mortality [odds ratio (OR): 1.26, 95% confidence interval (CI): 1.11–1.44, p = 0.003; I(2) = 64%] and major adverse cardiovascular events (MACEs; OR: 1.36, 95% CI: 1.12–1.66, p = 0.002, I(2) = 79%), but not with late (follow-up durations from 1 to 13 years) mortality (OR: 1.03, 95% CI: 0.95–1.13, p = 0.44, I(2) = 46%) or MACEs (OR: 1.03, 95% CI: 0.97–1.09, p = 0.38, I(2) = 0%). Meta-regression showed that the study characteristics of patient number, age, sex, diabetic status, and proportion of patients with prior PCI did not affect the outcomes. Sensitivity analyses limited to multivariate studies excluding patients with acute PCI failure showed similar results (early mortality, OR: 1.25, p = 0.003; early MACE, OR: 1.50, p = 0.001; late mortality, OR: 1.03, p = 0.70). CONCLUSION: The current evidence, mostly from retrospective observational studies, suggests that prior PCI is related to poor early clinical outcomes, but not to late clinical outcomes, after CABG. |
format | Online Article Text |
id | pubmed-9109498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-91094982022-05-17 Prior percutaneous coronary intervention and outcomes in patients after coronary artery bypass grafting: a meta-analysis of 308,284 patients Zhang, Hongliang Zhao, Zhenyan Yao, Jing Zhao, Jie Hou, Tao Wang, Moyang Xu, Yanlu Wang, Bincheng Niu, Guannan Sui, Yonggang Song, Guangyuan Wu, Yongjian Ther Adv Chronic Dis Meta-Analysis BACKGROUND: The association between prior percutaneous coronary intervention (PCI) and prognosis after coronary artery bypass grafting (CABG) remains uncertain. We aimed to evaluate the aforementioned association in a meta-analysis. METHODS: PubMed, Cochrane’s Library, and Embase databases were searched for potential studies. A random-effects model was used for the meta-analysis. Meta-regression was performed to evaluate the influence of study characteristics on the outcomes. RESULTS: Thirty-six follow-up studies with 308,284 patients were included, and 40,892 (13.3%) patients had prior PCI. Pooled results showed that prior PCI was associated with higher risks of early (in-hospital or within 1 month) all-cause mortality [odds ratio (OR): 1.26, 95% confidence interval (CI): 1.11–1.44, p = 0.003; I(2) = 64%] and major adverse cardiovascular events (MACEs; OR: 1.36, 95% CI: 1.12–1.66, p = 0.002, I(2) = 79%), but not with late (follow-up durations from 1 to 13 years) mortality (OR: 1.03, 95% CI: 0.95–1.13, p = 0.44, I(2) = 46%) or MACEs (OR: 1.03, 95% CI: 0.97–1.09, p = 0.38, I(2) = 0%). Meta-regression showed that the study characteristics of patient number, age, sex, diabetic status, and proportion of patients with prior PCI did not affect the outcomes. Sensitivity analyses limited to multivariate studies excluding patients with acute PCI failure showed similar results (early mortality, OR: 1.25, p = 0.003; early MACE, OR: 1.50, p = 0.001; late mortality, OR: 1.03, p = 0.70). CONCLUSION: The current evidence, mostly from retrospective observational studies, suggests that prior PCI is related to poor early clinical outcomes, but not to late clinical outcomes, after CABG. SAGE Publications 2022-05-13 /pmc/articles/PMC9109498/ /pubmed/35586304 http://dx.doi.org/10.1177/20406223221078755 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Meta-Analysis Zhang, Hongliang Zhao, Zhenyan Yao, Jing Zhao, Jie Hou, Tao Wang, Moyang Xu, Yanlu Wang, Bincheng Niu, Guannan Sui, Yonggang Song, Guangyuan Wu, Yongjian Prior percutaneous coronary intervention and outcomes in patients after coronary artery bypass grafting: a meta-analysis of 308,284 patients |
title | Prior percutaneous coronary intervention and outcomes in patients
after coronary artery bypass grafting: a meta-analysis of 308,284
patients |
title_full | Prior percutaneous coronary intervention and outcomes in patients
after coronary artery bypass grafting: a meta-analysis of 308,284
patients |
title_fullStr | Prior percutaneous coronary intervention and outcomes in patients
after coronary artery bypass grafting: a meta-analysis of 308,284
patients |
title_full_unstemmed | Prior percutaneous coronary intervention and outcomes in patients
after coronary artery bypass grafting: a meta-analysis of 308,284
patients |
title_short | Prior percutaneous coronary intervention and outcomes in patients
after coronary artery bypass grafting: a meta-analysis of 308,284
patients |
title_sort | prior percutaneous coronary intervention and outcomes in patients
after coronary artery bypass grafting: a meta-analysis of 308,284
patients |
topic | Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109498/ https://www.ncbi.nlm.nih.gov/pubmed/35586304 http://dx.doi.org/10.1177/20406223221078755 |
work_keys_str_mv | AT zhanghongliang priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT zhaozhenyan priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT yaojing priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT zhaojie priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT houtao priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT wangmoyang priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT xuyanlu priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT wangbincheng priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT niuguannan priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT suiyonggang priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT songguangyuan priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients AT wuyongjian priorpercutaneouscoronaryinterventionandoutcomesinpatientsaftercoronaryarterybypassgraftingametaanalysisof308284patients |