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eluting stents or coronary artery bypass grafting for unprotected left main coronary artery disease : a meta-analysis of four randomized trials and seventeen observational studies
| Content Provider | Semantic Scholar |
|---|---|
| Author | Chen, Meng-Hua Pan, Shangling |
| Copyright Year | 2013 |
| Abstract | Background: The clinical application of drug-eluting stents (DES) or coronary a rtery bypass grafting (CABG) for unprotected left main coronary artery di sease (ULMCAD) is still controversial. The purpose of this meta-analysis was to compare t he safety and efficacy between DES and CABG for ULMCAD. Methods: Databases of MEDLINE, EMBASE and the Cochrane Library were s ystematically searched. Results: Twenty-one studies with 8413 patients were included in this meta-ana lysis. The risk was lower in DES than in CABG groups at the early outcomes of dea th ([risk ratio (RR): 0.49, 95% confidence interval (CI): 0.30–0.78 ]), cerebrovascular events (RR: 0.19, 95% CI: 0.08–0.45) and composite endpoint (RR: 0.53, 95% CI: 0.40–0.70); death of 2 -years (RR: 0.81, 95% CI: 0.66–0.99), 4 -years (RR: 0.69, 95% CI: 0.53–0.90), 5 -years (OR: 0.76, 95% CI: 0.61–0.95) and their total effect (RR: 0.79, 95% CI: 0.71–0.87); composite endpoint of 1-year (RR: 0.69, 95% CI: 0.58–0.83), 4 -years (RR: 0.69, 95% CI: 0.53–0.88), 5 -years (RR: 0.74, 95% CI: 0.59–0.92) and their total effect (RR: 0.78, 95% CI: 0.71–0.85). There were no significant difference in the risk for the early outcomes of myocardial infarction MI (RR: 0.97, 95% CI: 0.68–1.38), death of 1 -years (OR: 0.81, 95% CI: 0.57–1.15) and 3 -years (OR: 0.85, 95% CI: 0.69–1.04), composite endpoint of 2 -years (RR: 0.88, 95% CI: 0.72–1.09) and 3-years (RR: 0.87, 95% CI: 0.73–1.04). Nonetheless, there was a lower risk for revascularization associated with CABG from 1 to 5-years and their total effect (RR: 3.77, 95% CI: 3.35–4.26). There was no difference in death, myocardial infarction MI, cerebrovascular events or revascularization in 1-year between RCT and observat ional groups. Conclusions: Our meta-analysis indicates that DES has higher safety but higher revascularization than CABG in patients with ULMCAD in the 5 yea rs fter intervention. Therefore, DES may be a better alternative for ULMCAD. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://static-content.springer.com/openpeerreview/art:10.1186%2F1745-6215-14-133/13063_2012_1311_AuthorComment_V2.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
