Journal article
Long-Term Outcomes of Left Main Coronary Artery Disease TreatedWith Drug-Eluting Stents vs Coronary Artery Bypass Grafting: A Meta-Analysis and Systematic Review
Cardiovascular revascularization medicine, Vol.23, pp.14-19
02/01/2021
DOI: 10.1016/j.carrev.2020.07.013
PMID: 32736979
Abstract
Background: Currently, DES is a reasonable treatment option for LMCA disease but CABG continues to be first-line treatment. Multiple randomized clinical trials (RCTs) have compared outcomes between these two treatment modalities. Recently, these trials published their long-term results with conflicting findings.
Methods: We conducted a systematic review and meta-analysis of RCTs that compared DES vs CABG in patients with LMCA disease. Weonly included trials with followup duration of at least 5 years. The primary outcome was all-causemortality. Secondary outcomes included risk of cardiac death, myocardial infarction (MI), stroke and repeat revascularization. Results: Weincluded a total of 4 RCTs. The median-weighted followup periodwas 6.5 years. Therewas no significant difference between DES and CABG in all-cause mortality (Risk ratio (RR) 1.10; 95% confidence interval (CI) 0.92 to 1.31; p = 0.28), risk of cardiac death (RR of 1.08, 95% CI 0.84 to 1.38; p = 0.56), totalMI (RR of 1.22, 95% CI 0.96 to 1.56; p = 0.11), and stroke (RR of 0.85, 95% CI 0.46 to 1.57; p = 0.60). The risk of repeat revascularization (RR of 1.75, 95% CI 1.50 to 2.03; p < 0.00001), and non-periprocedural MI (RR of 2.13, 95% CI 1.53 to 2.97; p < 0.00001) were significantly higher in the DES arm.
Conclusions: DES has similar long-term outcomes compared to CABG in terms of all-cause mortality, cardiac death, total MI and stroke; but was associated with a higher risk of repeat revascularization, and nonperiprocedural MI. (C) 2020 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Long-Term Outcomes of Left Main Coronary Artery Disease TreatedWith Drug-Eluting Stents vs Coronary Artery Bypass Grafting: A Meta-Analysis and Systematic Review
- Creators
- Abdullah Al-Abcha - Michigan State UniversityYehia Saleh - Methodist HospitalMark Mujer - Michigan State UniversityKhader Herzallah - Tufts Medical CenterGeorge S. Abela - Michigan State University
- Resource Type
- Journal article
- Publication Details
- Cardiovascular revascularization medicine, Vol.23, pp.14-19
- Publisher
- Elsevier
- DOI
- 10.1016/j.carrev.2020.07.013
- PMID
- 32736979
- ISSN
- 1553-8389
- eISSN
- 1878-0938
- Number of pages
- 6
- Language
- English
- Date published
- 02/01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984755387402771
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