SynthesisEuropean heart journal. Quality of care & clinical outcomes2021
Percutaneous vs. surgical revascularization for patients with unprotected left main stenosis: a meta-analysis of 5-year follow-up randomized controlled trials.
Synthesis in European heart journal. Quality of care & clinical outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled 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.
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
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality of Life After Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- Korean Society of Interventional Cardiology Expert Consensus for the Management of Chronic Coronary Syndrome: Part 2.Korean circulation journal · 2026Review
- Comparison of percutaneous coronary intervention vs coronary artery bypass graft for left main coronary artery disease in patients with prior cerebrovascular disease: A systematic review, meta-analysis and meta-regression.International journal of cardiology. Cardiovascular risk and prevention · 2025Review
- New Modifiable Risk Factors Influencing Coronary Artery Disease Severity.International journal of molecular sciences · 2024Review
- Left Main Coronary Artery Disease: A Contemporary Review of Diagnosis and Management.Reviews in cardiovascular medicine · 2024Review
- [Clinical outcomes of percutaneous intervention on the unprotected left main coronary artery].Revista medica del Instituto Mexicano del Seguro Social · 2024Observational
- Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions.Medicina (Kaunas, Lithuania) · 2023Article
- Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Revascularization of Left Main Coronary Artery Disease.Korean circulation journal · 2023Review
- Recent Evidence on Advances in PCI Treatment for Left Main Coronary Artery Disease.Reviews in cardiovascular medicine · 2022Review
- Left Main Coronary Artery Disease-Current Management and Future Perspectives.Journal of clinical medicine · 2022Review
- Prediction of All-Cause Mortality Following Percutaneous Coronary Intervention in Bifurcation Lesions Using Machine Learning Algorithms.Journal of personalized medicine · 2022Article
- Percutaneous Coronary Intervention for Left Main Coronary Artery Disease: Present Status and Future Perspectives.JACC. Asia · 2022Review
- Outcomes of Left Main Revascularization after Percutaneous Intervention or Bypass Surgery.Journal of interventional cardiology · 2022Article
- The year in cardiovascular medicine 2020: interventional cardiology.European heart journal · 2021Article
- Long-Term Outcomes of Patients with Unprotected Left Main Coronary Artery Disease Treated with Percutaneous Angioplasty versus Bypass Grafting: A Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
aimsA 5-year survival of patients with unprotected left main (ULM) stenosis according to the choice of revascularization (percutaneous vs. surgical) remains to be defined. METHODS AND
resultsRandomized controlled trials (RCTs) comparing percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG) with a follow-up of at least 5 years were included. All-cause death was the primary endpoint. MACCE [a composite endpoint of all-cause mortality, myocardial infarction (MI), stroke, and repeat revascularization] along with its single components and cardiovascular (CV) death were the secondary ones. Analyses were stratified according to the use of first- vs. last-generation coronary stents. Subgroup comparisons were performed according to SYNTAX score (below or above 33) and to age (using cut-offs of each trial's subgroup analysis). Four RCTs with 4394 patients were identified: 2197 were treated with CABG, 657 with first generation, and 1540 with last-generation stents. At 5-year rates of all-cause death did not differ [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.71-1.21], as those of CV death and stroke. Coronary artery bypass graft reduced rates of MACCE (OR 0.69, 95% CI 0.60-0.79), mainly driven by MI (OR 0.48, 95% CI 0.36-0.65) and revascularization (OR 0.53, 95% CI 0.45-0.64). Benefit of CABG for MACCE was consistent, although with different extent, across values of SYNTAX score (OR 0.76, 95% CI 0.59-0.97 for values < 32 and OR 0.63, 95% CI 0.47-0.84 for values ≥ 33) while was not evident for 'younger' patients (OR 0.83, 95% CI 0.65-1.07 vs. OR 0.65, 95% CI 0.51-0.84 for 'older' patients).
conclusionFor patients with ULM disease followed-up for 5 years, no significant difference was observed in all-cause and cardiovascular death between PCI and CABG. Coronary artery bypass graft reduced risk of MI, revascularization, and MACCE especially in older patients and in those with complex coronary disease and a high SYNTAX score.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.