Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis
Background and AimsData are emerging on 10-year mortality comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stenting for multivessel disease (MVD) without left main (LM) involvement. We conducted an updated two-stage meta-analysis using reconstructed...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-03-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.822228/full |
| _version_ | 1811332280092721152 |
|---|---|
| author | Nicholas W. S. Chew Jin Hean Koh Cheng Han Ng Darren Jun Hao Tan Jie Ning Yong Chaoxing Lin Oliver Zi-Hern Lim Yip Han Chin Denzel Ming Wei Lim Koo Hui Chan Koo Hui Chan Poay-Huan Loh Poay-Huan Loh Adrian Low Adrian Low Chi-Hang Lee Chi-Hang Lee Huay-Cheem Tan Huay-Cheem Tan Mark Chan Mark Chan |
| author_facet | Nicholas W. S. Chew Jin Hean Koh Cheng Han Ng Darren Jun Hao Tan Jie Ning Yong Chaoxing Lin Oliver Zi-Hern Lim Yip Han Chin Denzel Ming Wei Lim Koo Hui Chan Koo Hui Chan Poay-Huan Loh Poay-Huan Loh Adrian Low Adrian Low Chi-Hang Lee Chi-Hang Lee Huay-Cheem Tan Huay-Cheem Tan Mark Chan Mark Chan |
| author_sort | Nicholas W. S. Chew |
| collection | DOAJ |
| description | Background and AimsData are emerging on 10-year mortality comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stenting for multivessel disease (MVD) without left main (LM) involvement. We conducted an updated two-stage meta-analysis using reconstructed individual patient data to compare long-term mortality between CABG and PCI for patients with MVD without significant LM coronary disease.MethodsMedline and Embase databases were searched for articles comparing CABG with PCI for MVD. A two-stage meta-analysis was conducted using reconstructed patient level survival data for all-cause mortality with subgroups by SYNTAX score. The shared-frailty and stratified Cox models were fitted to compare survival endpoints.ResultsWe screened 1,496 studies and included six randomized controlled trials with 7,181 patients. PCI was associated with greater 10-year all-cause mortality risk (HR: 1.282, CI: 1.118–1.469, p < 0.001) compared with CABG. In patients with low SYNTAX score, 10-year all-cause mortality after PCI was comparable to CABG (HR: 1.102, 0.822–1.479, p = 0.516). However, in patients with moderate to high SYNTAX score, 10-year all-cause mortality was significantly higher after PCI compared with CABG (HR: 1.444, 1.122–1.858, p < 0.001; HR: 1.856, 1.380–2.497, p < 0.001, respectively).ConclusionThis updated reconstructed individual patient-data meta-analysis revealed a sustained lower cumulative all-cause mortality of CABG over PCI for multivessel disease without LM involvement. |
| first_indexed | 2024-04-13T16:33:33Z |
| format | Article |
| id | doaj.art-914867700ebc43528fb271f70f268ebd |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T16:33:33Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-914867700ebc43528fb271f70f268ebd2022-12-22T02:39:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-03-01910.3389/fcvm.2022.822228822228Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-AnalysisNicholas W. S. Chew0Jin Hean Koh1Cheng Han Ng2Darren Jun Hao Tan3Jie Ning Yong4Chaoxing Lin5Oliver Zi-Hern Lim6Yip Han Chin7Denzel Ming Wei Lim8Koo Hui Chan9Koo Hui Chan10Poay-Huan Loh11Poay-Huan Loh12Adrian Low13Adrian Low14Chi-Hang Lee15Chi-Hang Lee16Huay-Cheem Tan17Huay-Cheem Tan18Mark Chan19Mark Chan20Department of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeBackground and AimsData are emerging on 10-year mortality comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stenting for multivessel disease (MVD) without left main (LM) involvement. We conducted an updated two-stage meta-analysis using reconstructed individual patient data to compare long-term mortality between CABG and PCI for patients with MVD without significant LM coronary disease.MethodsMedline and Embase databases were searched for articles comparing CABG with PCI for MVD. A two-stage meta-analysis was conducted using reconstructed patient level survival data for all-cause mortality with subgroups by SYNTAX score. The shared-frailty and stratified Cox models were fitted to compare survival endpoints.ResultsWe screened 1,496 studies and included six randomized controlled trials with 7,181 patients. PCI was associated with greater 10-year all-cause mortality risk (HR: 1.282, CI: 1.118–1.469, p < 0.001) compared with CABG. In patients with low SYNTAX score, 10-year all-cause mortality after PCI was comparable to CABG (HR: 1.102, 0.822–1.479, p = 0.516). However, in patients with moderate to high SYNTAX score, 10-year all-cause mortality was significantly higher after PCI compared with CABG (HR: 1.444, 1.122–1.858, p < 0.001; HR: 1.856, 1.380–2.497, p < 0.001, respectively).ConclusionThis updated reconstructed individual patient-data meta-analysis revealed a sustained lower cumulative all-cause mortality of CABG over PCI for multivessel disease without LM involvement.https://www.frontiersin.org/articles/10.3389/fcvm.2022.822228/fullmultivessel coronary artery disease (MVD)coronary artery bypass grafting (CABG)percutaneous coronary interventionmortalitycoronary artery |
| spellingShingle | Nicholas W. S. Chew Jin Hean Koh Cheng Han Ng Darren Jun Hao Tan Jie Ning Yong Chaoxing Lin Oliver Zi-Hern Lim Yip Han Chin Denzel Ming Wei Lim Koo Hui Chan Koo Hui Chan Poay-Huan Loh Poay-Huan Loh Adrian Low Adrian Low Chi-Hang Lee Chi-Hang Lee Huay-Cheem Tan Huay-Cheem Tan Mark Chan Mark Chan Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis Frontiers in Cardiovascular Medicine multivessel coronary artery disease (MVD) coronary artery bypass grafting (CABG) percutaneous coronary intervention mortality coronary artery |
| title | Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis |
| title_full | Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis |
| title_fullStr | Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis |
| title_full_unstemmed | Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis |
| title_short | Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis |
| title_sort | coronary artery bypass grafting versus percutaneous coronary intervention for multivessel coronary artery disease a one stage meta analysis |
| topic | multivessel coronary artery disease (MVD) coronary artery bypass grafting (CABG) percutaneous coronary intervention mortality coronary artery |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.822228/full |
| work_keys_str_mv | AT nicholaswschew coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT jinheankoh coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT chenghanng coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT darrenjunhaotan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT jieningyong coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT chaoxinglin coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT oliverzihernlim coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT yiphanchin coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT denzelmingweilim coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT koohuichan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT koohuichan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT poayhuanloh coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT poayhuanloh coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT adrianlow coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT adrianlow coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT chihanglee coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT chihanglee coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT huaycheemtan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT huaycheemtan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT markchan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis AT markchan coronaryarterybypassgraftingversuspercutaneouscoronaryinterventionformultivesselcoronaryarterydiseaseaonestagemetaanalysis |