Cirugía de revascularización miocárdica versus angioplastía coronaria con stent en enfermedad de tres vasos y/o tronco común izquierdo en diabéticos: meta-análisis de estudios aleatorios / Meta-analysis of coronary artery bypass surgery compared to percutaneous transluminal angioplasty with stent in diabetic patients
Rev. méd. Chile
;
140(5): 640-648, mayo 2012. ilus, tab
Artigo
em Espanhol
| LILACS
| ID: lil-648593
ABSTRACT
Background:
Diabetic patients are a group of primary interest in the study of myocardial revascularization.Aim:
To compare coronary artery bypass grafting surgery (CABG) and percutaneous angioplasty with stents (PCI-S) in diabetic patients with coronary three-vessel or left main coronary artery disease. Material andMethods:
Meta-analysis of MEDLINE randomized controlled studies comparing CABG and PCI-S in diabetic patients. The primary outcome measure was major adverse cardiovascular events (MACCE), death, myocardial infarction, cerebrovascular accident (CVA) and coronary re-intervention. Secondary outcomes were the individual components of MACCE.Results:
Three studies comparing CABG and PCI-S met the inclusion criteria. One thousand sixty two patients were studied 565 in the CABG group and 597 in the PCI-S group. At one year follow up MACCE occurred in 24.9 and 12.7% of patients in PCI-S and CABG groups, respectively (Odds ratio (OR) 2.27; 95% confidence intervals (CI) 1.66-3.09). There were no differences in death or myocardial infarction. Strokes were less common in the PCI-S group (OR 0.25, 95% CI0.09-0.68) and coronary re-intervention was required with higher frequency in the PCI-S group (OR 5.32, 95% CI 3.27-8.67).Conclusions:
In diabetic patients with three-vessel coronary disease or left main coronary artery, revascularization with CABG had significantly less MACCE at one year than those treated with PCI-S. Stroke frequency was higher in CABG, coronary re-intervention was higher in PCI-S. These results must be interpreted cautiously.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Doença da Artéria Coronariana
/
Stents
/
Ponte de Artéria Coronária
/
Angioplastia
/
Cardiomiopatias Diabéticas
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo de etiologia
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2012
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Hospital Dr. Guillermo Grant Benavente/CL
/
Pontificia Universidad Católica de Chile/CL
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