Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis
Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI)...
Ausführliche Beschreibung
Autor*in: |
Fang-Yang Huang [verfasserIn] Bao-Tao Huang [verfasserIn] Yong Peng [verfasserIn] Wei Liu [verfasserIn] Peng-Ju Wang [verfasserIn] Mao Chen [verfasserIn] Ye Zhu [verfasserIn] |
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E-Artikel |
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Englisch |
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2016 |
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Schlagwörter: |
Percutaneous coronary intervention |
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Übergeordnetes Werk: |
In: International Cardiovascular Forum Journal - Barcaray International, 2017, 6(2016), Seite 54-60 |
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Übergeordnetes Werk: |
volume:6 ; year:2016 ; pages:54-60 |
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DOAJ011362170 |
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520 | |a Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. | ||
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(DE-627)DOAJ011362170 (DE-599)DOAJ4d54f180f32240aaa3f908f30a48b831 DE-627 ger DE-627 rakwb eng RC666-701 Fang-Yang Huang verfasserin aut Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. Percutaneous coronary intervention Coronary artery bypass graft Left ventricular systolic dysfunction Meta-analysis Medicine R Diseases of the circulatory (Cardiovascular) system Bao-Tao Huang verfasserin aut Yong Peng verfasserin aut Wei Liu verfasserin aut Peng-Ju Wang verfasserin aut Mao Chen verfasserin aut Ye Zhu verfasserin aut In International Cardiovascular Forum Journal Barcaray International, 2017 6(2016), Seite 54-60 (DE-627)859466345 (DE-600)2855971-X 24093424 nnns volume:6 year:2016 pages:54-60 https://doi.org/10.17987/icfj.v6i0.191 kostenfrei https://doaj.org/article/4d54f180f32240aaa3f908f30a48b831 kostenfrei http://icfjournal.org/index.php/icfj/article/view/191/pdf-2 kostenfrei https://doaj.org/toc/2410-2636 Journal toc kostenfrei https://doaj.org/toc/2409-3424 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 54-60 |
spelling |
(DE-627)DOAJ011362170 (DE-599)DOAJ4d54f180f32240aaa3f908f30a48b831 DE-627 ger DE-627 rakwb eng RC666-701 Fang-Yang Huang verfasserin aut Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. Percutaneous coronary intervention Coronary artery bypass graft Left ventricular systolic dysfunction Meta-analysis Medicine R Diseases of the circulatory (Cardiovascular) system Bao-Tao Huang verfasserin aut Yong Peng verfasserin aut Wei Liu verfasserin aut Peng-Ju Wang verfasserin aut Mao Chen verfasserin aut Ye Zhu verfasserin aut In International Cardiovascular Forum Journal Barcaray International, 2017 6(2016), Seite 54-60 (DE-627)859466345 (DE-600)2855971-X 24093424 nnns volume:6 year:2016 pages:54-60 https://doi.org/10.17987/icfj.v6i0.191 kostenfrei https://doaj.org/article/4d54f180f32240aaa3f908f30a48b831 kostenfrei http://icfjournal.org/index.php/icfj/article/view/191/pdf-2 kostenfrei https://doaj.org/toc/2410-2636 Journal toc kostenfrei https://doaj.org/toc/2409-3424 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 54-60 |
allfields_unstemmed |
(DE-627)DOAJ011362170 (DE-599)DOAJ4d54f180f32240aaa3f908f30a48b831 DE-627 ger DE-627 rakwb eng RC666-701 Fang-Yang Huang verfasserin aut Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. Percutaneous coronary intervention Coronary artery bypass graft Left ventricular systolic dysfunction Meta-analysis Medicine R Diseases of the circulatory (Cardiovascular) system Bao-Tao Huang verfasserin aut Yong Peng verfasserin aut Wei Liu verfasserin aut Peng-Ju Wang verfasserin aut Mao Chen verfasserin aut Ye Zhu verfasserin aut In International Cardiovascular Forum Journal Barcaray International, 2017 6(2016), Seite 54-60 (DE-627)859466345 (DE-600)2855971-X 24093424 nnns volume:6 year:2016 pages:54-60 https://doi.org/10.17987/icfj.v6i0.191 kostenfrei https://doaj.org/article/4d54f180f32240aaa3f908f30a48b831 kostenfrei http://icfjournal.org/index.php/icfj/article/view/191/pdf-2 kostenfrei https://doaj.org/toc/2410-2636 Journal toc kostenfrei https://doaj.org/toc/2409-3424 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 54-60 |
allfieldsGer |
(DE-627)DOAJ011362170 (DE-599)DOAJ4d54f180f32240aaa3f908f30a48b831 DE-627 ger DE-627 rakwb eng RC666-701 Fang-Yang Huang verfasserin aut Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. Percutaneous coronary intervention Coronary artery bypass graft Left ventricular systolic dysfunction Meta-analysis Medicine R Diseases of the circulatory (Cardiovascular) system Bao-Tao Huang verfasserin aut Yong Peng verfasserin aut Wei Liu verfasserin aut Peng-Ju Wang verfasserin aut Mao Chen verfasserin aut Ye Zhu verfasserin aut In International Cardiovascular Forum Journal Barcaray International, 2017 6(2016), Seite 54-60 (DE-627)859466345 (DE-600)2855971-X 24093424 nnns volume:6 year:2016 pages:54-60 https://doi.org/10.17987/icfj.v6i0.191 kostenfrei https://doaj.org/article/4d54f180f32240aaa3f908f30a48b831 kostenfrei http://icfjournal.org/index.php/icfj/article/view/191/pdf-2 kostenfrei https://doaj.org/toc/2410-2636 Journal toc kostenfrei https://doaj.org/toc/2409-3424 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 54-60 |
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(DE-627)DOAJ011362170 (DE-599)DOAJ4d54f180f32240aaa3f908f30a48b831 DE-627 ger DE-627 rakwb eng RC666-701 Fang-Yang Huang verfasserin aut Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. Percutaneous coronary intervention Coronary artery bypass graft Left ventricular systolic dysfunction Meta-analysis Medicine R Diseases of the circulatory (Cardiovascular) system Bao-Tao Huang verfasserin aut Yong Peng verfasserin aut Wei Liu verfasserin aut Peng-Ju Wang verfasserin aut Mao Chen verfasserin aut Ye Zhu verfasserin aut In International Cardiovascular Forum Journal Barcaray International, 2017 6(2016), Seite 54-60 (DE-627)859466345 (DE-600)2855971-X 24093424 nnns volume:6 year:2016 pages:54-60 https://doi.org/10.17987/icfj.v6i0.191 kostenfrei https://doaj.org/article/4d54f180f32240aaa3f908f30a48b831 kostenfrei http://icfjournal.org/index.php/icfj/article/view/191/pdf-2 kostenfrei https://doaj.org/toc/2410-2636 Journal toc kostenfrei https://doaj.org/toc/2409-3424 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 54-60 |
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Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. |
abstractGer |
Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. |
abstract_unstemmed |
Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD. Methods The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction <50%) were included. Random- and fixed-effect models were used depending on between-study heterogeneity. Results Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG. Conclusions Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion. |
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Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft among Patients with Coronary Artery Disease and Left Ventricular Systolic Dysfunction: A Meta-Analysis |
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https://doi.org/10.17987/icfj.v6i0.191 https://doaj.org/article/4d54f180f32240aaa3f908f30a48b831 http://icfjournal.org/index.php/icfj/article/view/191/pdf-2 https://doaj.org/toc/2410-2636 https://doaj.org/toc/2409-3424 |
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Bao-Tao Huang Yong Peng Wei Liu Peng-Ju Wang Mao Chen Ye Zhu |
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