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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
Sá, Michel Pompeu Barros Oliveira; Perazzo, Álvaro Monteiro; Saragiotto, Felipe Augusto Santos; Cavalcanti, Luiz Rafael Pereira; Almeida Neto, Antônio Carlos Escorel; Campos, Jéssica Cordeiro Siqueira; Braga, Paulo Guilherme Bezerra; Rayol, Sérgio da Costa; Diniz, Roberto Gouvea Silva; Sá, Frederico Browne Correia Araújo; Lima, Ricardo Carvalho.
  • Sá, Michel Pompeu Barros Oliveira; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Perazzo, Álvaro Monteiro; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Saragiotto, Felipe Augusto Santos; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Cavalcanti, Luiz Rafael Pereira; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Almeida Neto, Antônio Carlos Escorel; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Campos, Jéssica Cordeiro Siqueira; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Braga, Paulo Guilherme Bezerra; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Rayol, Sérgio da Costa; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Diniz, Roberto Gouvea Silva; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Sá, Frederico Browne Correia Araújo; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
  • Lima, Ricardo Carvalho; Pronto Socorro Cardiológico de Pernambuco - PROCAPE. Division of Cardiovascular Surgery. Recife. BR
Rev. bras. cir. cardiovasc ; 34(4): 396-405, July-Aug. 2019. tab, graf
Article Dans Anglais | 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.
Sujets)


Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Pontage aortocoronarien / Ischémie myocardique / Accident vasculaire cérébral / Intervention coronarienne percutanée / Défaillance cardiaque Type d'étude: Essai clinique contrôlé / Etude d'étiologie / Guide de pratique / Étude pronostique / Facteurs de risque / Revues systématiques évaluées Limites du sujet: Adulte très âgé / Femelle / Humains / Mâle Pays comme sujet: Amérique du Sud / Brésil langue: Anglais Texte intégral: Rev. bras. cir. cardiovasc Thème du journal: Cardiologie / Chirurgie générale Année: 2019 Type: Article Pays d'affiliation: Brésil Institution/Pays d'affiliation: Pronto Socorro Cardiológico de Pernambuco - PROCAPE/BR

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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Pontage aortocoronarien / Ischémie myocardique / Accident vasculaire cérébral / Intervention coronarienne percutanée / Défaillance cardiaque Type d'étude: Essai clinique contrôlé / Etude d'étiologie / Guide de pratique / Étude pronostique / Facteurs de risque / Revues systématiques évaluées Limites du sujet: Adulte très âgé / Femelle / Humains / Mâle Pays comme sujet: Amérique du Sud / Brésil langue: Anglais Texte intégral: Rev. bras. cir. cardiovasc Thème du journal: Cardiologie / Chirurgie générale Année: 2019 Type: Article Pays d'affiliation: Brésil Institution/Pays d'affiliation: Pronto Socorro Cardiológico de Pernambuco - PROCAPE/BR