Evidence map›Paper›PMID 34045061›Full record

SynthesisThe Journal of thoracic and cardiovascular surgery2023

Difference in spontaneous myocardial infarction and mortality in percutaneous versus surgical revascularization trials: A systematic review and meta-analysis.

Mario Gaudino, Antonino Di Franco, Cristiano Spadaccio, Mohamed Rahouma, N Bryce Robinson, Michelle Demetres, Stephen Fremes, Torsten Doenst

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of thoracic and cardiovascular surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
3.8field-weighted citation impact, top 6% 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, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. Recent innovations in aortic valve surgery: True progress?Turk gogus kalp damar cerrahisi dergisi · 2023
    Article
  8. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Mario GaudinoDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY. Electronic address: mfg9004@med.cornell.edu.
Antonino Di FrancoDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
Cristiano SpadaccioDepartment of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom.
Mohamed RahoumaDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
N Bryce RobinsonDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
Michelle DemetresSamuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, NY.
Stephen FremesDivision of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Torsten DoenstDepartment of Cardiothoracic Surgery, University Hospital Jena, Friedrich Schiller University of Jena, Jena, Germany.
Cornell University · USWeill Cornell Medicine · USFriedrich Schiller University Jena · DEGolden Jubilee National Hospital · GBHealth Sciences Centre · CA

Funding

Randomized comparison of the clinical Outcome of single versus Multiple Arterial grafts: Quality of Life (ROMA:QOL)R01HL152021 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI GAUDINO, MARIO FL, MASTERSON CREBER, RUTH MARIE · 2020 to 2024
$4.1M
NHLBI NIH HHS R01 HL152021
6 · The paper itself

Abstract

objectivesIt has been hypothesized that the survival benefit of coronary artery bypass (CABG) compared with percutaneous interventions (PCI) may be associated with the reduction in spontaneous myocardial infarction (SMI) achieved by surgery. This, however, has not been formally investigated. The present meta-analysis aims to evaluate the association between the difference in SMI and in survival in PCI versus CABG randomized controlled trials (RCTs).

methodsA systematic search was performed to identify all RCTs comparing PCI with CABG for the treatment of coronary artery disease and reporting SMI outcomes. Generic inverse variance method was used to pool outcomes as natural logarithms of the incident rate ratios across studies. Subgroup analysis and interaction test were used to compare the difference of the primary outcome among trials that did and did not report a significant reduction in SMI- in the patients treated by CABG. Primary outcome was all-cause mortality; secondary outcome was SMI.

resultsTwenty RCTs were included in the meta-analysis. A statistically significant difference in SMI in favor of CABG was found in 7 of the included trials (35%). Overall, PCI was associated with significantly greater all-cause mortality (incident rate ratio, 1.13; 95% confidence interval, 1.01-1.28). At subgroup analysis, a significant difference in survival in favor of CABG was seen only in trials that reported a significant reduction in SMI in the surgical arm (P for interaction 0.02).

conclusionsIn the published PCI versus CABG trials, the reduction in all-cause mortality in the surgical arm is associated with the protective effect of CABG against SMI.

Indexed as

Coronary Artery DiseaseMyocardial InfarctionPercutaneous Coronary InterventionCoronary Artery BypassHumansTreatment OutcomeCABGmyocardial infarctionPCI

Identifiers

PMID34045061
PMCPMC8802340
OpenAlexW3157758945

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.