Document Detail


Meta-analysis of three randomized trials and nine observational studies comparing drug-eluting stents versus coronary artery bypass grafting for unprotected left main coronary artery disease.
MedLine Citation:
PMID:  22877423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinical outcomes for unprotected left main coronary artery (ULMCA) disease between coronary artery bypass grafting (CABG) and drug-eluting stents (DESs) remain controversial. We aimed to compare the safety and efficacy of percutaneous coronary intervention (PCI) using DESs with CABG in patients with ULMCA disease. Databases were searched for clinical studies that reported outcomes after PCI with DESs and CABG for treatment of ULMCA disease. End points of this meta-analysis were mortality; composite of death, myocardial infarction (MI), or stroke; and target vessel revascularization at 1-year follow-up. Pooled effects were calculated using fixed-effects model (Mantel-Haenszel method) or random-effects models (Dersimonian-Laird method). Twelve clinical studies (3 randomized trials and 9 observational studies) with 5,079 patients were involved in this study. At 1-year follow-up, there were trends toward lower risk of death (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.45 to 1.02) and the composite end point of death, MI, or stroke (OR 0.70, 95% CI 0.49 to 1.00) in the DES group compared to the CABG group. However, target vessel revascularization was significantly higher in the DES group compared to the CABG group (OR 3.52, 95% CI 2.72 to 4.56). In conclusion, PCI with DESs is associated with favorable outcomes for mortality; composite end point of death, MI, or stroke; and a higher risk of target vessel revascularization compared to CABG in patients with ULMCA disease.
Authors:
Jae-Sik Jang; Kyu-Nam Choi; Han-Young Jin; Jeong-Sook Seo; Tae-Hyun Yang; Dae-Kyeong Kim; Dong-Soo Kim; Sang-Hwa Urm; Jin Ho Chun; Soo-Jin Kang; Duk-Woo Park; Seung-Whan Lee; Young-Hak Kim; Cheol Whan Lee; Seong-Wook Park; Seung-Jung Park
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2012-08-08
Journal Detail:
Title:  The American journal of cardiology     Volume:  110     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-29     Completed Date:  2013-01-08     Revised Date:  2013-04-23    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1411-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Busan Paik Hospital, University of Inje College of Medicine, Busan, Korea.
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass / methods*
Coronary Artery Disease / surgery*
Drug-Eluting Stents*
Humans
Randomized Controlled Trials as Topic*
Comments/Corrections
Comment In:
Am J Cardiol. 2013 Apr 1;111(7):1076-8   [PMID:  23498088 ]

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