医学
传统PCI
狼牙棒
经皮冠状动脉介入治疗
内科学
血运重建
冠状动脉疾病
心脏病学
冲程(发动机)
随机对照试验
纳入和排除标准
经皮
外科
心肌梗塞
机械工程
替代医学
病理
工程类
作者
Juan Guido Chiabrando,Giovanni Maria Vescovo,Marco Lombardi,Marco Giuseppe Del Buono,Francisco Romeo,Daniel Berrocal,Luis A. Guzman,Giuseppe Biondi-Zoccai,Antonio Abbate
标识
DOI:10.23736/s2724-5683.20.05370-0
摘要
Long-term efficacy and safety of either surgical or percutaneous treatment left main coronary artery disease treatment is lacking.We conducted a systematic review and meta-analysis of the most updated randomized clinical trials that compared the efficacy of coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) for the Left Main Coronary Artery (LMCA) disease. It was also conducted a systematic search of PubMed, Google Scholar, reference lists of relevant articles, and Medline. The search utilized the following terms: "left main PCI versus CABG," "drug-eluting stents," "bypass surgery" and "left main stenting." The search of articles compatible with our inclusion and exclusion criteria was performed from inception through April 2020 and returned a combined total of 304 articles.We identified 6 studies, providing data on 5812 patients. The mean follow-up was 6.7 years. PCI was associated with an increased risk of major vascular events (MACE) (IRR 1.24, 95% CI [1.03-1.67], P<0.01), and coronary revascularization (IRR 1.69, 95% CI [1.42-2.03], P<0.01) compared to CABG. Furthermore, all-cause death, MI and stroke events were not statistically different between the two therapeutic revascularization methodologies (IRR 1.06, 95% CI [0.90-1.24], P=0.47, IRR 1.35, 95% CI [0.84-2.16], P=0.03 and IRR 0.66, 95% CI [0.43-1.01], P=0.05, respectively).LMCA PCI has an overall same survival compared to CABG in the long term follow-up. Nevertheless, MACE and revascularization events were more frequent in PCI compared to CABG.
科研通智能强力驱动
Strongly Powered by AbleSci AI