Evidence map›Paper›PMID 28296170›Full record

SynthesisCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2017

Percutaneous coronary intervention or coronary artery bypass grafting for unprotected left main coronary artery disease.

Ahmed N Mahmoud, Islam Y Elgendy, Amgad Mentias, Marwan Saad, Walid Ibrahim, Mohammad K Mojadidi, Ramez Nairooz, Parham Eshtehardi, R David Anderson, Habib Samady

Abstract readMeta-AnalysisReview
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In one paragraph

Synthesis in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Ahmed N MahmoudDivision of Cardiovascular Medicine, University of Florida, Gainesville, Florida.
Islam Y ElgendyDivision of Cardiovascular Medicine, University of Florida, Gainesville, Florida.ORCID http://orcid.org/0000-0001-9853-7591
Amgad MentiasDivision of Cardiovascular Medicine, University of Iowa, Iowa City, Iowa.
Marwan SaadDivision of Cardiovascular Medicine, University of Arkansas, Little Rock, Arkansas.ORCID http://orcid.org/0000-0002-2280-8030
Walid IbrahimDepartment of Medicine, Wayne State University, Detroit, Michigan.
Mohammad K MojadidiDivision of Cardiovascular Medicine, University of Florida, Gainesville, Florida.
Ramez NairoozDivision of Cardiovascular Medicine, University of Arkansas, Little Rock, Arkansas.
Parham EshtehardiDivision of Cardiovascular Medicine, Emory University School of Medicine, Atlanta, Georgia.
R David AndersonDivision of Cardiovascular Medicine, University of Florida, Gainesville, Florida.
Habib SamadyDivision of Cardiovascular Medicine, Emory University School of Medicine, Atlanta, Georgia.
University of Florida · USEmory University · USUniversity of Arkansas at Little Rock · USUniversity of Iowa · USWayne State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent trials comparing PCI with CABG for unprotected left main disease yielded discrepant evidence.

objectivesTo perform an updated meta-analysis of randomized trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease.

methodsRandomized trials comparing PCI versus CABG for patients with unprotected left main coronary artery disease were included. Summary estimates risk ratios (RRs) were performed with a DerSimonian and Laird model at short-term, intermediate and long-term follow-up periods (i.e., 30-days, 1-year, and >1-year). Outcomes evaluated were major adverse cardiac and cerebrovascular events (MACCE), all-cause mortality, myocardial infarction, stroke, revascularization and stent thrombosis or symptomatic graft occlusion.

resultsSix trials with 4,700 patients and a mean SYNTAX score of 23 were included. At short-term follow-up, the risk of MACCE was lower with PCI (RR 0.55, 95% confidence interval [CI] 0.39-0.76) driven by the lower risk of myocardial infarction (RR 0.67, 95% CI 0.46-0.99), and stroke (RR 0.38, 95% CI 0.16-0.90). The risk of MACCE was similar at the intermediate follow-up (RR 1.21, 95% CI 0.97-1.51). At long-term follow-up, PCI was associated with a higher risk of MACCE (RR 1.19, 95% CI 1.01-1.41), due to a higher risk of revascularization (RR 1.62, 95% CI 1.34-1.94), while the risk of all-cause mortality, myocardial infarction, and stroke were similar.

conclusionsIn patients with unprotected left main coronary disease and low to intermediate SYNTAX score, PCI might be an acceptable alternative to CABG. © 2017 Wiley Periodicals, Inc.

Indexed as

Coronary Artery BypassPercutaneous Coronary InterventionAgedClinical Decision-MakingCoronary AngiographyCoronary Artery DiseaseCoronary ThrombosisFemaleGraft Occlusion, VascularHumansMaleMiddle AgedMyocardial InfarctionOdds RatioPatient SelectionRandomized Controlled Trials as Topiccoronary artery bypass graftingcoronary artery diseasemortalitypercutaneous coronary interventionstroke

Identifiers

PMID28296170
OpenAlexW2601739442

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.