Coronary Artery Bypass Graft Surgery Improves Survival Without Increasing the Risk of Stroke in Patients with Ischemic Heart Failure in Comparison to Percutaneous Coronary Intervention: A Meta-Analysis With 54,173 Patients

• Published in: Revista brasileira de cirurgia cardiovascular 2019-01, Vol.34 (4), p.396-405
• Main Authors: Sá, Michel Pompeu Barros Oliveira, Perazzo, Álvaro Monteiro, Saragiotto, Felipe Augusto Santos, Cavalcanti, Luiz Rafael Pereira, Almeida, Neto, Antônio Carlos Escorel, Campos, Jéssica Cordeiro Siqueira, Braga, Paulo Guilherme Bezerra, Rayol, Sérgio da Costa, Diniz, Roberto Gouvea Silva, Sá, Frederico Browne Correia Araújo, Lima, Ricardo Carvalho
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty; Brazil - epidemiology; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiology; Coronary Artery Bypass; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Epidemiologic Methods; Evidence-Based Medicine; Female; Heart Failure; Heart Failure - surgery; Heart surgery; Humans; Male; Meta-Analysis; Mortality; Multicenter Studies as Topic; Myocardial Ischemia - mortality; Myocardial Ischemia - surgery; Original; Percutaneous Coronary Intervention; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - mortality; Postoperative Complications - etiology; Postoperative Complications - mortality; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Stents; Stroke - etiology; Stroke - mortality; Studies; SURGERY; Treatment Outcome
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2019-0170

To evaluate whether there is any difference on the results of patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in the setting of ischemic heart failure (HF). Databases (MEDLINE, Embase, Cochrane Controlled Trials Register [CENTRAL/CCTR], ClinicalTrials.gov, Scientific Electronic Library Online [SciELO], Literatura Latino-americana e do Caribe em Ciências da Saúde [LILACS], and Google Scholar) were searched for studies published until February 2019. Main outcomes of interest were mortality, myocardial infarction, repeat revascularization, and stroke. The search yielded 5,775 studies for inclusion. Of these, 20 articles were analyzed, and their data were extracted. The total number of patients included was 54,173, and those underwent CABG (N=29,075) or PCI (N=25098). The hazard ratios (HRs) for mortality (HR 0.763; 95% confidence interval [CI] 0.678-0.859; P