SynthesisBMJ open2015
Has the difference in mortality between percutaneous coronary intervention and coronary artery bypass grafting in people with heart disease and diabetes changed over the years? A systematic review and meta-regression.
Synthesis in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 27 citations in OpenAlex.
- Bypassing the blues: Insomnia in the depressed post-CABG population.Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists · 2020Trial
- Evolution of the Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG) Indication and Mortality Rates in Spain from 2010 to 2019.Journal of cardiovascular development and disease · 2024Article
- Long-term survival in patients who had CABG with or without prior coronary artery stenting.Open heart · 2020Article
- The Effect of Glycemic Control on Cardiac Outcomes in Saudi Diabetic Patients who Underwent Coronary Angiogram.Heart views : the official journal of the Gulf Heart AssociationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine the difference in outcome between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), to see if it has changed over the years in diabetics deemed eligible for both treatments; and to contrast the long-term mortality findings with those in non-diabetics.
designMeta-analyses using data from randomised controlled trials found by searches on MEDLINE, EMBASE and the Cochrane Controlled Trials Register, from their inception until March 2015.
settingStudies had to be randomised controlled trials comparing PCI with CABG.
participantsThose taking part in the studies had to have multivessel cardiac or left main artery cardiac disease and be deemed eligible for both treatments.
interventionsPCI or CABG. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was all cause mortality. Secondary outcomes were a composite of mortality, stroke and myocardial infarction; cardiovascular death; and MACCE (Major Adverse Cardiac or Cerebrovascular Event). The longest follow-up was used in the analysis.
resultsAmong 14 studies (4868 diabetics) reported over three decades, meta-regression shows no relationship between the year of publication and the difference in long term all cause mortality between PCI and CABG. CABG has maintained an approximately 30% mortality advantage compared to PCI. The other outcomes used showed the same lack of change over the years. These findings held true among insulin-requiring and non-insulin-requiring diabetics. However, among non-diabetics included in the 14 studies, there was no difference in mortality outcome between PCI and CABG.
conclusionsThe difference in outcome between PCI and CABG in diabetics has not narrowed from the beginning-with balloon angioplasty to current PCI-with the second generation of drug eluting stents. In contrast to the non-diabetics, there is a persistent 30% benefit in all cause mortality favouring CABG in diabetics, and this should be a major factor in treatment recommendation.
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