Coronary artery bypass graft surgery improves survival without increasing the risk of stroke in patients with ischemic heart failure in comparison to percutaneous coronary intervention: a meta-analysis with 54, 173 patients
Rev. bras. cir. cardiovasc
;
34(4): 396-405, July-Aug. 2019. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-1020497
ABSTRACT
Abstract Objective:
To evaluate whether there is any difference on the results of patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in the setting of ischemic heart failure (HF).Methods:
Databases (MEDLINE, Embase, Cochrane Controlled Trials Register [CENTRAL/CCTR], ClinicalTrials.gov, Scientific Electronic Library Online [SciELO], Literatura Latino-americana e do Caribe em Ciências da Saúde [LILACS], and Google Scholar) were searched for studies published until February 2019. Main outcomes of interest were mortality, myocardial infarction, repeat revascularization, and stroke.Results:
The search yielded 5,775 studies for inclusion. Of these, 20 articles were analyzed, and their data were extracted. The total number of patients included was 54,173, and those underwent CABG (N=29,075) or PCI (N=25098). The hazard ratios (HRs) for mortality (HR 0.763; 95% confidence interval [CI] 0.678-0.859; P<0.001), myocardial infarction (HR 0.481; 95% CI 0.365-0.633; P<0.001), and repeat revascularization (HR 0.321; 95% CI 0.241-0.428; P<0.001) were lower in the CABG group than in the PCI group. The HR for stroke showed no statistically significant difference between the groups (random effect model HR 0.879; 95% CI 0.625-1.237; P=0.459).Conclusion:
This meta-analysis found that CABG surgery remains the best option for patients with ischemic HF, without increase in the risk of stroke.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Puente de Arteria Coronaria
/
Isquemia Miocárdica
/
Accidente Cerebrovascular
/
Intervención Coronaria Percutánea
/
Insuficiencia Cardíaca
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio de etiología
/
Guía de Práctica Clínica
/
Estudio pronóstico
/
Factores de riesgo
/
Revisiones Sistemáticas Evaluadas
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Rev. bras. cir. cardiovasc
Asunto de la revista:
Cardiología
/
Cirugía General
Año:
2019
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Pronto Socorro Cardiológico de Pernambuco - PROCAPE/BR
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