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Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials
BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of th...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931946/ https://www.ncbi.nlm.nih.gov/pubmed/36815952 http://dx.doi.org/10.48305/arya.2022.24252 |
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author | Davari, Majid Sorato, Mende Mensa Fatemi, Behzad Rezaei, Soheila Sanei, Hamid |
author_facet | Davari, Majid Sorato, Mende Mensa Fatemi, Behzad Rezaei, Soheila Sanei, Hamid |
author_sort | Davari, Majid |
collection | PubMed |
description | BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of this disease. The main aim of this study was the comparison of MT with PCI or CABG in terms of cardiovascular (CV) mortality, myocardial infarction (MI), unplanned revascularization (UR), stroke, and freedom from angina in managing stable CAD. METHODS: The Cochrane Central Register of Controlled Trials, Embase, PubMed, and Scopus were searched. Two reviewers independently appraised the titles and abstracted data of the identified studies. After the Full-text reviewing phase, eligible studies were analyzed through the random-effect meta-analysis method. Finally, a sensitivity analysis was conducted for the robustness of findings. RESULTS: Nine randomized controlled trials (RCTs) were included. The pooled RR of CV mortality associated with MT compared with PCI and CABG was 1.22 and 1.385, respectively. Overall, The RR of MT associated with MI, UR, stroke, and freedom from angina compared with PCI was 1.001, 1.151, 0.799, and 0.801, respectively. CONCLUSION: Our results revealed no statistically significant difference between MT and PCI in terms of studied primary outcomes. The findings also highlighted that there is no statistically significant difference between MT and CABG in terms of CV mortality. |
format | Online Article Text |
id | pubmed-9931946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-99319462023-02-17 Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials Davari, Majid Sorato, Mende Mensa Fatemi, Behzad Rezaei, Soheila Sanei, Hamid ARYA Atheroscler Meta-Analysis BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of this disease. The main aim of this study was the comparison of MT with PCI or CABG in terms of cardiovascular (CV) mortality, myocardial infarction (MI), unplanned revascularization (UR), stroke, and freedom from angina in managing stable CAD. METHODS: The Cochrane Central Register of Controlled Trials, Embase, PubMed, and Scopus were searched. Two reviewers independently appraised the titles and abstracted data of the identified studies. After the Full-text reviewing phase, eligible studies were analyzed through the random-effect meta-analysis method. Finally, a sensitivity analysis was conducted for the robustness of findings. RESULTS: Nine randomized controlled trials (RCTs) were included. The pooled RR of CV mortality associated with MT compared with PCI and CABG was 1.22 and 1.385, respectively. Overall, The RR of MT associated with MI, UR, stroke, and freedom from angina compared with PCI was 1.001, 1.151, 0.799, and 0.801, respectively. CONCLUSION: Our results revealed no statistically significant difference between MT and PCI in terms of studied primary outcomes. The findings also highlighted that there is no statistically significant difference between MT and CABG in terms of CV mortality. Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences 2022-05 /pmc/articles/PMC9931946/ /pubmed/36815952 http://dx.doi.org/10.48305/arya.2022.24252 Text en © 2022 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences https://creativecommons.org/licenses/by-nc/3.0/This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly. |
spellingShingle | Meta-Analysis Davari, Majid Sorato, Mende Mensa Fatemi, Behzad Rezaei, Soheila Sanei, Hamid Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
title | Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
title_full | Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
title_fullStr | Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
title_full_unstemmed | Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
title_short | Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
title_sort | medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials |
topic | Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931946/ https://www.ncbi.nlm.nih.gov/pubmed/36815952 http://dx.doi.org/10.48305/arya.2022.24252 |
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