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Long-Term Outcomes of Patients with Unprotected Left Main Coronary Artery Disease Treated with Percutaneous Angioplasty versus Bypass Grafting : A Meta-Analysis of Randomized Controlled Trials
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- Bajraktari, Gani (author)
- Umeå universitet,Kardiologi,Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo
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Zhubi-Bakija, Fjolla (author)
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Ndrepepa, Gjin (author)
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Alfonso, Fernando (author)
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Elezi, Shpend (author)
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Rexhaj, Zarife (author)
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- Bytyçi, Ibadete (author)
- Umeå universitet,Kardiologi,Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo
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- Bajraktari, Artan (author)
- Umeå universitet,Kardiologi
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Poniku, Afrim (author)
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- Henein, Michael Y. (author)
- Umeå universitet,Kardiologi
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(creator_code:org_t)
- 2020-07-14
- 2020
- English.
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In: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:7
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https://umu.diva-por... (primary) (Raw object)
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Abstract
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- Background and Aim: Treatment of patients with left main coronary artery disease (LMCA) with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains controversial. The aim of this meta-analysis was to compare the long-term clinical outcomes of patients with unprotected LMCA treated randomly by PCI or CABG. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov database searches identified five randomized trials (RCTs) including 4499 patients with unprotected LMCA comparing PCI (n= 2249) vs. CABG (n= 2250), with a minimum clinical follow-up of five years. Random effect risk ratios were used for efficacy and safety outcomes. The study was registered in PROSPERO. The primary outcome was major adverse cardiac events (MACE), defined as a composite of death from any cause, myocardial infarction or stroke. Results: Compared to CABG, patients assigned to PCI had a similar rate of MACE (risk ratio (RR): 1.13; 95% CI: 0.94 to 1.36;p= 0.19), myocardial infarction (RR: 1.48; 95% CI: 0.97 to 2.25;p= 0.07) and stroke (RR: 0.87; 95% CI: 0.62 to 1.23;p= 0.42). Additionally, all-cause mortality (RR: 1.07; 95% CI: 0.89 to 1.28;p= 0.48) and cardiovascular (CV) mortality (RR: 1.13; 95% CI: 0.89 to 1.43;p= 0.31) were not different. However, the risk of any repeat revascularization (RR: 1.70; 95% CI: 1.34 to 2.15;p< 0.00001) was higher in patients assigned to PCI. Conclusions: The findings of this meta-analysis suggest that the long-term survival and MACE of patients who underwent PCI for unprotected LMCA stenosis were comparable to those receiving CABG, despite a higher rate of repeat revascularization.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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Bajraktari, Gani
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Zhubi-Bakija, Fj ...
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Ndrepepa, Gjin
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Alfonso, Fernand ...
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Elezi, Shpend
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Rexhaj, Zarife
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Bytyçi, Ibadete
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Bajraktari, Arta ...
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Poniku, Afrim
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Henein, Michael ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Umeå University