Major cardiovascular events at 5 years in surgical versus percutaneous revascularization for left main stem disease: an updated meta-analysis

被引：5

作者：

Urso, Stefano ^{[1
]}

Sadaba, Rafel ^{[2
]}

Nogales, Eliu ^{[3
]}

Maria Gonzalez, Jesus ^{[4
]}

Angeles Tena, Maria ^{[1
]}

Paredes, Federico ^{[1
]}

Gonzalez-Barbeito, Miguel ^{[1
]}

Portela, Francisco ^{[1
]}

机构：

[1] Hosp Univ Dr Negrin, Cardiac Surg Dept, Las Palmas Gran Canaria, Spain

[2] Complejo Hosp Navarra, Cardiac Surg Dept, Pamplona, Spain

[3] Hosp Univ Insular, Cardiol Dept, Las Palmas Gran Canaria, Spain

[4] Hosp Univ Dr Negrin, Res Unit, Las Palmas Gran Canaria, Spain

来源：

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY | 2021年 / 32卷 / 04期

关键词：

Meta-analysis; Coronary artery bypass grafting; Drug-eluting stent; Left main disease; Percutaneous coronary intervention; 5-YEAR OUTCOMES; SURGERY; CABG; PCI;

D O I：

10.1093/icvts/ivaa301

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aim of the present study was to analyse the incidence of major adverse cardiovascular events in patients undergoing either coronary artery bypass grafting (CABG) or percutaneous coronary intervention with drug-eluting stents for left main stem disease. Five manuscripts publishing 5-year results of 4 trials (SYNTAX, PRECOMBAT, NOBLE and EXCEL) were included. Overall meta-analysis with inclusion of the 5-year results from the EXCEL trial using the protocol definition for myocardial infarction showed that CABG is associated with a significant reduction in the risk of major adverse cardiovascular events (MACE) (risk ratio = 0.74; 95% confidence interval = 0.68-0.80). When the universal definition was used to define myocardial infarction in the EXCEL trial, the analysis demonstrated a larger benefit of coronary surgery in terms of reduction in the risk of MACE (risk ratio = 0.70; 95% confidence interval = 0.63-0.76). Non-significant differences were detected in terms of risk of overall mortality, cardiac mortality or stroke. In conclusion, this meta-analysis shows that CABG significantly reduces the risk of MACE in patients with left main stem disease. The inclusion of the 5-year results of the EXCEL trial using third universal definition amplifies the benefit of CABG over percutaneous coronary intervention.

引用

页码：530 / 536

页数：7

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