Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis

Chew, Nicholas; Koh, Jin Hean; Ng, Cheng Han; Tan, Darren Jun Hao; Yong, Jie Ning; Lin, Chaoxing; Lim, Oliver Zi Hern; Chin, Yip Han; Lim, Denzel Ming Wei; Chan, Koo Hui; Loh, Poay-Huan; Low, Adrian; Lee, Chi‐Hang; Tan, Huay‐Cheem; Chan, Mark Y

doi:10.3389/fcvm.2022.822228

Cited by 8 publications

(10 citation statements)

References 56 publications

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“…in a number of parameters, including survival. At the same time, meta-analyses by Chew et al and Brown et al revealed the advantage of CABG over PCI in patients with multivessel disease and intermediate and high Syntax scores(25,26), and comparable results for individuals with low SS(26). Our study revealed a predominance in the frequency of MACCE in patients with intermediate SS who underwent PCI compared with those who underwent CABG (81 % and 50 %, re-…”

supporting

confidence: 74%

“…For example, in our study, we retrospectively selected patients who underwent CABG or PCI under actual clinical conditions. Meanwhile, in recent meta-analyses (24)(25)(26)28) comprising RCTs in which the investigators compared the outcomes of PCI and CABG, disparate approaches were implemented to determine study endpoints, and a different composition of SS groups would have affected the authors' recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 200 patients underwent primary PCI with DES placement (n = 200, 100 patients with an SS ≤ 22; and 100 patients with an SS of 23-32). Two hundred six patients also underwent CABG (n = 206, 100 patients with SS ≤ 22; and 106 patients with an SS of [23][24][25][26][27][28][29][30][31][32].…”

Section: Baseline Characteristicsmentioning

confidence: 99%

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Long-term results of myocardial revascularization in patients with multivessel disease

Madiyeva¹,

Aripov²,

Pya³

et al. 2023

BLL

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BACKGROUND: Choosing the method of revascularization -coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) -remains debatable. METHODS: We selected 406 patients with multivessel disease who underwent PCI with a drug-eluting stent (DES) (n = 200, 100 with a SYNTAX score (SS) ≤ 22 and 100 with a SS 23-32); and CABG (n = 206, 100 with a SS ≤ 22 and 106 with a SS 23-32). The mean follow-up period was 9±1.9 years. The endpoints of the study were as follows: major adverse cardiac and cerebrovascular events (МАССЕ), a repeat revascularization (RR), diminished left ventricular ejection fraction (LVEF), and high SS in dynamics. RESULTS: Patients with an intermediate SS needed RR more often with PCI than after CABG (64 % vs 22.6 %; HR: 3.52; CI: 2.19-5.66; р < 0.001). We found no signifi cant differences for other MACCE between the groups. The decrease in LVEF was greater in the low SS subgroup in operated patients than after PCI (39.5 % vs 27.7 %; HR: 0.57; CI: 0.34-0.98; p = 0.04). The difference between the initial and fi nal SS, was greater after the CABG than after PCI (43.5 % vs 10.9 %; HR: 0.26; CI: 0.14-0.47; р < 0.001). CONCLUSIONS: After 9 ± 1.9 years in intermediate SS group CABG exhibited an advantage over PCI with DES in terms of the MACCE indicators due to a smaller number of RR in the CABG group. The CABG group showed a more signifi cant progression of atherosclerosis, and more heart failure cases (Tab. 2, Fig. 4, Ref. 29).

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supporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Long-term results of myocardial revascularization in patients with multivessel disease

Madiyeva¹,

Aripov²,

Pya³

et al. 2023

BLL

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“…Two studies, Lu et al 21 and Venuraju et al 22 did not report the HRs or 95% CI; hence, a web-based plot digitizing tool, WebPlotDigitizer, 23 was used to extract them from their respective Kaplan-Meier curves and reproduced them to obtain a HR using another software that reconstructs individual patient data from Kaplan-Meier curves, IPDfromKM. [24][25][26] An example of how this was done is demonstrated in the Supplemental Methods.…”

Section: Se =mentioning

confidence: 99%

Epicardial Adipose Tissue Assessed by Computed Tomography and Echocardiography Are Associated With Adverse Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Chong

Jayabaskaran

Ruban

et al. 2023

Circ: Cardiovascular Imaging

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Background: Epicardial adipose tissue (EAT) has garnered attention as a prognostic and risk stratification factor for cardiovascular disease. This study, via meta-analyses, evaluates the associations between EAT and cardiovascular outcomes stratified across imaging modalities, ethnic groups, and study protocols. Methods: Medline and Embase databases were searched without date restriction on May 2022 for articles that examined EAT and cardiovascular outcomes. The inclusion criteria were (1) studies measuring EAT of adult patients at baseline and (2) reporting follow-up data on study outcomes of interest. The primary study outcome was major adverse cardiovascular events. Secondary study outcomes included cardiac death, myocardial infarction, coronary revascularization, and atrial fibrillation. Results: Twenty-nine articles published between 2012 and 2022, comprising 19 709 patients, were included in our analysis. Increased EAT thickness and volume were associated with higher risks of cardiac death (odds ratio, 2.53 [95% CI, 1.17–5.44]; P =0.020; n=4), myocardial infarction (odds ratio, 2.63 [95% CI, 1.39–4.96]; P =0.003; n=5), coronary revascularization (odds ratio, 2.99 [95% CI, 1.64–5.44]; P <0.001; n=5), and atrial fibrillation (adjusted odds ratio, 4.04 [95% CI, 3.06–5.32]; P <0.001; n=3). For 1 unit increment in the continuous measure of EAT, computed tomography volumetric quantification (adjusted hazard ratio, 1.74 [95% CI, 1.42–2.13]; P <0.001) and echocardiographic thickness quantification (adjusted hazard ratio, 1.20 [95% CI, 1.09–1.32]; P <0.001) conferred an increased risk of major adverse cardiovascular events. Conclusions: The utility of EAT as an imaging biomarker for predicting and prognosticating cardiovascular disease is promising, with increased EAT thickness and volume being identified as independent predictors of major adverse cardiovascular events. Registration: URL: https://www.crd.york.ac.uk/prospero ; Unique identifier: CRD42022338075.

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“…With the advancement of the PCI, such as the design of stents, higher-risk patients with more complex coronary lesions have been included in trials [ 24 ]. As such, we found relative mortality benefits of CABG over PCI in this study, especially in patients with multivessel CAD.…”

Section: Reviewmentioning

confidence: 99%

Comparative Effectiveness of Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention for Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Clinical Trials

Shaik¹,

Chaudhari²,

Haider³

et al. 2022

Cureus

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Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery are the options for revascularization in coronary artery disease (CAD). This meta-analysis aims to compare the efficacy of CABG and PCI for the management of patients with CAD. The meta-analysis was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane Library, and EMBASE were searched for relevant articles. The reference list of included articles was also searched manually for additional publications. Primary endpoints were cardiovascular mortality and all-cause mortality. Secondary endpoints included myocardial infarction, stroke, and revascularization. In total, 12 randomized control trials (RCTs) were included in this meta-analysis encompassing 9,941 patients (4,954 treated with CABG and 4,987 with PCI). The analysis showed that PCI was associated with a higher risk of all-cause mortality (risk ratio (RR) = 1.26, 95% confidence interval (CI) = 1.10-1.45) and revascularization (RR = 2.42, 95% CI = 1.82-3.21). However, no significant differences were reported between two arms regarding cardiovascular mortality (RR = 1.15, 95% CI = 0.96-1.39), myocardial infarction (RR = 1.17, 95% CI = 0.82-1.67), and stroke (RR = 0.64, 95% CI = 0.35-1.16). CABG was associated with a significant reduction in all-cause mortality and revascularization compared to PCI. However, no significant difference was reported in the risk of cardiovascular mortality, myocardial infarction, and stroke between the two groups.

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Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis

Cited by 8 publications

References 56 publications

Long-term results of myocardial revascularization in patients with multivessel disease

Long-term results of myocardial revascularization in patients with multivessel disease

Epicardial Adipose Tissue Assessed by Computed Tomography and Echocardiography Are Associated With Adverse Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Comparative Effectiveness of Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention for Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Clinical Trials

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