SynthesisBMC medicine2017
Percutaneous intervention versus coronary artery bypass graft surgery in left main coronary artery stenosis: a systematic review and meta-analysis.
Synthesis in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The effect of diabetes on surgical versus percutaneous left main revascularization outcomes: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2022Pooled it
- Percutaneous coronary intervention versus cardiac bypass surgery for left main coronary artery disease: A trial sequential analysis.Medicine · 2017Pooled it
- Mortality Outcome Post-MI after PCI and CABG Interventions.Global heart · 2026Article
- Impact of an enhanced recovery after surgery program integrating cardiopulmonary rehabilitation on post-operative prognosis of patients treated with CABG: protocol of the ERAS-CaRe randomized controlled trial.BMC pulmonary medicine · 2024Article
- Causal fairness assessment of treatment allocation with electronic health records.Journal of biomedical informatics · 2024Article
- Review
- Time-resolved simulation of blood flow through left anterior descending coronary artery: effect of varying extent of stenosis on hemodynamics.BMC cardiovascular disorders · 2023Article
- An empirical evaluation of the impact scenario of pooling bodies of evidence from randomized controlled trials and cohort studies in medical research.BMC medicine · 2022Article
- Transcription factor Foxp1 stimulates angiogenesis in adult rats after myocardial infarction.Cell death discovery · 2022Article
- Review
- Evaluating agreement between bodies of evidence from randomized controlled trials and cohort studies in medical research: a meta-epidemiological study.BMC medicine · 2022Article
- Mitochondrial Damage in Myocardial Ischemia/Reperfusion Injury and Application of Natural Plant Products.Oxidative medicine and cellular longevity · 2022Review
- Approaches to therapeutic angiogenesis for ischemic heart disease.Journal of molecular medicine (Berlin, Germany) · 2019Review
- Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studies.Diabetology & metabolic syndrome · 2019Article
- The Current State of Left Main Percutaneous Coronary Intervention.Current atherosclerosis reports · 2018Review
- Fractional flow reserve [FFR] guided stenting of left main coronary artery in acute coronary syndrome: A single centre experience.Indian heart journalObservational
- Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD.
methodsPubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016.
resultsSix randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included. PCI was associated with an overall higher risk for the major adverse cardiac and cerebrovascular events (hazard ratio (HR), 1.42; 95% confidence interval (CI), 1.14-1.77), mainly driven by higher rates of myocardial infarction (HR, 1.69; 95% CI, 1.22-2.34) and revascularization (HR, 2.80; 95% CI, 1.86-4.22). The overall risks for all-cause death (HR, 1.05; 95% CI, 0.93-1.20), cardiac death (HR, 1.05; 95% CI, 0.69-1.59), stroke (HR, 0.64; 95% CI, 0.33-1.24), and the composite safety endpoint of death, myocardial infarction, or stroke (HR, 1.06; 95% CI, 0.97-1.16) were similar between PCI and CABG. Stratified analysis based on stent types showed that the increased risk for myocardial infarction associated with PCI was only evident in patients with bare-metal stents or early-generation drug-eluting stents (DES), but not newer-generation DES. Stratified analyses based on study designs showed largely similar findings with the overall analyses, except for a significantly higher incidence of myocardial infarction in adjusted studies (HR, 2.01; 95% CI, 1.64-2.45) but a trend toward higher incidence in randomized trials (HR, 1.39; 95% CI, 0.85-2.27) associated with PCI.
conclusionsCompared with CABG, PCI with newer-generation DES might be a safe alternative revascularization strategy for treatment of left main CAD, but is associated with more repeat revascularization.
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