@article{ACS16494,
author = {Mohamed Rahouma and Ahmed Abouarab and Antonino Di Franco and Jeremy R. Leonard and Christopher Lau and Mohamed Kamel and Lucas B. Ohmes and Leonard N. Girardi and Mario Gaudino},
title = {Percutaneous coronary intervention versus coronary bypass surgery for unprotected left main disease: a meta-analysis of randomized controlled trials},
journal = {Annals of Cardiothoracic Surgery},
volume = {7},
number = {4},
year = {2018},
keywords = {},
abstract = {Background: This meta-analysis of randomized controlled trials (RCTs) was aimed at comparing coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for the treatment of unprotected left main coronary disease.
Methods: All RCTs randomizing patients to any type of PCI with stents vs. CABG for left main disease (LMD) were included. Primary outcome was a composite of follow-up death/myocardial infarction/stroke/repeat revascularization. Secondary outcomes were peri-procedural mortality and the individual components of the primary outcome. Incidence rate ratio (IRR) or odds ratio (OR) and 95% confidence intervals (CIs) were pooled using a generic inverse variance method with random effects model. Subgroup analyses were done based on: (I) type of PCI [bare metal stents (BMS) vs. drug-eluting stents (DES)] and; (II) mean SYNTAX score tertiles. Leave one-out analysis and meta-regression were performed.<
Results: Six trials were included (4,700 patients; 2,349 PCI and 2,351 CABG). Follow-up ranged from 2.33 to 5 years. PCI was associated with higher risk of follow-up death/myocardial infarction/stroke/repeat revascularization (IRR =1.328, 95% CI, 1.114–1.582, P=0.002) and of repeated revascularization (IRR =1.754, 95% CI, 1.470–2.093, P},
issn = {2304-1021}, url = {https://www.annalscts.com/article/view/16494}
}