Document Detail


Minimally invasive direct coronary bypass grafting versus percutaneous coronary intervention for single-vessel disease: a meta-analysis of 2885 patients†
MedLine Citation:
PMID:  25100715     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Percutaneous coronary intervention (PCI) and minimally invasive direct coronary artery bypass (MIDCAB) grafting are both established therapeutic options for single-vessel disease of the left anterior descending artery (LAD). The present systematic review with meta-analysis aims to determine the current strength of evidence for or against PCI and MIDCAB for revascularization of the LAD. Therefore, we performed a meta-analysis of randomized, controlled trials (RCTs) and observational trials (OTs) that reported clinical outcome after isolated LAD revascularization. Analysed postoperative outcomes included major adverse cardiac and cerebrovascular events (MACCEs), all-cause mortality, myocardial infarction and stroke. Pooled treatment effects [odds ratio (OR) or weighted mean difference (WMD), 95% confidence intervals (95% CI)] were assessed using a fixed- or random-effects model. A total of 2885 patients from 12 studies (6 RCTs, 6 OTs) were identified after a literature search of major databases using a predefined list of keywords. PCI of the LAD was performed in 60.7% (n = 1751) and MIDCAB in 39.3% of patients (n = 1126). Pooled-effect estimates revealed an increased incidence for MACCEs after PCI (OR 1.98; 95% CI 1.45-2.69; P < 0.0001) 6 months after the procedure. Especially, PCI was particularly associated with an increased odds for target vessel revascularization (OR 2.11; 95% CI 1.00-4.47; P = 0.0295). No differences with regard to stroke, myocardial infarction and all-cause mortality were observed between both revascularization strategies. Patients after PCI had a shorter length of hospital stay (WMD -3.37 days; 95% CI (-)4.92 to (-)1.81; P < 0.0001). In conclusion, the present systematic review underscores the superiority of MIDCAB over PCI for treatment of single-vessel disease of the LAD.
Authors:
Antje-Christin Deppe; Oliver J Liakopoulos; Elmar W Kuhn; Ingo Slottosch; Maximilian Scherner; Yeong-Hoon Choi; Parwis B Rahmanian; Thorsten Wahlers
Related Documents :
6870005 - Furazolidone-induced congestive cardiomyopathy in ducklings: myocardial ultrastructural...
3075405 - Study of the effect of tensiomin (captopril) in chronic heart failure.
2120475 - Changes in sickness at admission following the introduction of the prospective payment ...
7085465 - Medical management of congestive heart failure in a horse.
15342305 - Effectiveness of oral propafenone for the prevention of atrial fibrillation after coron...
24067325 - Temporal trends in hospitalization for acute myocardial infarction between 2004 and 201...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-6
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  -     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  High-Fat Diet Induces Significant Metabolic Disorders in a Mouse Model of Polycystic Ovary Syndrome.
Next Document:  Neuropsychological performance of school-aged children after staged surgical palliation of hypoplast...