Percutaneous Coronary Intervention Versus Surgery in Left Main Stenosis-A Meta-Analysis and Systematic Review of Randomised Controlled Trials

Department

Internal Medicine

Document Type

Article

Publication Title

Heart, Lung & Circulation

Abstract

OBJECTIVE: To investigate the safety and efficacy of percutaneous coronary interventions (PCI) versus coronary artery bypass graft (CABG) surgery for left main coronary artery (LMCA) disease.

METHODS: Six randomised controlled trials (RCTs) were reviewed by searching PubMed/Medline, Embase and the Cochrane Library. Estimates were pooled according to random effects model. Binary outcomes were reported as risk ratio (RR) and continuous outcomes were reported as mean difference (MD) with 95% confidence interval (CI).

RESULTS: 3794 patients were randomised into PCI and CABG arms. Mean age of the total population was 64.7 years, 74.4% were male and mean Logistic EURO score (LES) was 2.9. When compared with CABG, patients treated with PCI had reduced risk of major adverse cardiovascular events (MACE) at 30 days: (RR: 0.55; 95% CI, 0.41-0.75; p

CONCLUSION: Percutaneous coronary intervention reduced MACE at 30days with comparable MACE at 1year. However, CABG was a more effective modality when considering mid- to long-term outcomes. PCI is a safer procedure with regards to periprocedural adverse events.

First Page

138

Last Page

146

DOI

10.1016/j.hlc.2017.08.008

Volume

27

Issue

2

Publication Date

2-1-2018

Medical Subject Headings

Coronary Angiography; Coronary Stenosis; Coronary Vessels; Drug-Eluting Stents; Humans; Percutaneous Coronary Intervention; Randomized Controlled Trials as Topic; Treatment Outcome

PubMed ID

28923395

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