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
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...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382019000400006&lng=en&tlng=en |
| _version_ | 1818253224830828544 |
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| author | Michel Pompeu Barros Oliveira Sá Álvaro Monteiro Perazzo Felipe Augusto Santos Saragiotto Luiz Rafael Pereira Cavalcanti Antônio Carlos Escorel Almeida Neto Jéssica Cordeiro Siqueira Campos Paulo Guilherme Bezerra Braga Sérgio da Costa Rayol Roberto Gouvea Silva Diniz Frederico Browne Correia Araújo Sá Ricardo Carvalho Lima |
| author_facet | Michel Pompeu Barros Oliveira Sá Álvaro Monteiro Perazzo Felipe Augusto Santos Saragiotto Luiz Rafael Pereira Cavalcanti Antônio Carlos Escorel Almeida Neto Jéssica Cordeiro Siqueira Campos Paulo Guilherme Bezerra Braga Sérgio da Costa Rayol Roberto Gouvea Silva Diniz Frederico Browne Correia Araújo Sá Ricardo Carvalho Lima |
| author_sort | Michel Pompeu Barros Oliveira Sá |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T16:36:41Z |
| format | Article |
| id | doaj.art-a9066643c7ae411faacb6de6b986872b |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-12-12T16:36:41Z |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-a9066643c7ae411faacb6de6b986872b2022-12-22T00:18:39ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-974134439640510.21470/1678-9741-2019-0170S0102-76382019000400006Coronary 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 PatientsMichel Pompeu Barros Oliveira SáÁlvaro Monteiro PerazzoFelipe Augusto Santos SaragiottoLuiz Rafael Pereira CavalcantiAntônio Carlos Escorel Almeida NetoJéssica Cordeiro Siqueira CamposPaulo Guilherme Bezerra BragaSérgio da Costa RayolRoberto Gouvea Silva DinizFrederico Browne Correia Araújo SáRicardo Carvalho LimaAbstract 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382019000400006&lng=en&tlng=enMeta-AnalysisCoronary Artery BypassStentsPercutaneous Coronary InterventionHeart Failure |
| spellingShingle | Michel Pompeu Barros Oliveira Sá Álvaro Monteiro Perazzo Felipe Augusto Santos Saragiotto Luiz Rafael Pereira Cavalcanti Antônio Carlos Escorel Almeida Neto Jéssica Cordeiro Siqueira Campos Paulo Guilherme Bezerra Braga Sérgio da Costa Rayol Roberto Gouvea Silva Diniz Frederico Browne Correia Araújo Sá Ricardo Carvalho Lima 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 Brazilian Journal of Cardiovascular Surgery Meta-Analysis Coronary Artery Bypass Stents Percutaneous Coronary Intervention Heart Failure |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Meta-Analysis Coronary Artery Bypass Stents Percutaneous Coronary Intervention Heart Failure |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382019000400006&lng=en&tlng=en |
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