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CABG surgery remains the best option for patients with left main coronary disease in comparison with pci-des: meta-analysis of randomized controlled trials
Sá, Michel Pompeu Barros Oliveira; Soares, Artur Freire; Miranda, Rodrigo Gusmão Albuquerque; Araújo, Mayara Lopes; Menezes, Alexandre Motta; Silva, Frederico Pires Vasconcelos; Lima, Ricardo Carvalho.
Afiliação
  • Sá, Michel Pompeu Barros Oliveira; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Soares, Artur Freire; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Miranda, Rodrigo Gusmão Albuquerque; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Araújo, Mayara Lopes; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Menezes, Alexandre Motta; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Silva, Frederico Pires Vasconcelos; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Lima, Ricardo Carvalho; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;32(5): 408-416, Sept.-Oct. 2017. tab, graf
Article em En | LILACS | ID: biblio-897945
Biblioteca responsável: BR1.1
ABSTRACT
Abstract

Objective:

To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease.

Methods:

MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies fulfilled our eligibility criteria and they included a total of 4.595 patients (2.298 for CABG and 2.297 for PCI with DES).

Results:

At 1-year follow-up, there was no significant difference between CABG and DES groups concerning the risk for death (risk ratio [RR] 0.973, P=0.830), myocardial infarction (RR 0.694, P=0.148), stroke (RR 1.224, P=0.598), and major adverse cerebrovascular and cardiovascular events (RR 0.948, P=0.680). The risk for target vessel revascularization (TVR) was significantly lower in the CABG group compared to the DES group (RR 0.583, P<0.001). It was observed no publication bias regarding the outcomes, but only the outcome TVR was free from substantial statistical heterogeneity of the effects. In the meta-regression, there was evidence that the factor "female gender" modulated the effect regarding myocardial infarction rates, favoring the CABG strategy.

Conclusion:

CABG surgery remains the best option of treatment for patients with ULMCA disease, with lower TVR rates.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Doença da Artéria Coronariana / Ponte de Artéria Coronária / Stents Farmacológicos Tipo de estudo: Clinical_trials / Systematic_reviews Limite: Humans Idioma: En Revista: Rev. bras. cir. cardiovasc Assunto da revista: CARDIOLOGIA / CIRURGIA GERAL Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Doença da Artéria Coronariana / Ponte de Artéria Coronária / Stents Farmacológicos Tipo de estudo: Clinical_trials / Systematic_reviews Limite: Humans Idioma: En Revista: Rev. bras. cir. cardiovasc Assunto da revista: CARDIOLOGIA / CIRURGIA GERAL Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil