Key result
CABG is linked to ~18% lower long-term death vs PCI in CAD with LV dysfunction.
Why the study?
Does coronary artery bypass grafting reduce long-term death compared to percutaneous coronary intervention in patients with coronary artery disease and left ventricular systolic dysfunction?
Meta-Analysis (n=6,082)
Does coronary artery bypass grafting reduce long-term death compared to percutaneous coronary intervention in patients with coronary artery disease and left ventricular systolic dysfunction?
Answers are grounded in this paper and cite their sources.
In patients with coronary artery disease and left ventricular systolic dysfunction, CABG is associated with significantly lower long-term mortality, myocardial infarction, and repeat revascularization compared to PCI.
The optimal method of coronary revascularization for patients with coronary artery disease (CAD) and left ventricular (LV) systolic dysfunction is unclear. The purpose of this meta-analysis was to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in these patients. Two investigators independently searched PubMed, EMBASE, and the Cochrane Controlled Trials Register databases for relevant studies. Four prospective and 5 retrospective studies, published before March 2015, involving 6082 patients were included. Compared with PCI, CABG was significantly associated with lower long-term death (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.70-0.96, P = .01, I 2 = 0%), myocardial infarction (OR: 0.58, 95% CI: 0.36-0.95, P = .03, I 2 = 44%), and repeat revascularization (OR: 0.17, 95% CI: 0.14-0.22, P < .001, I 2 = 32%). The short-term death rate was comparable between CABG and PCI (OR: 2.09, 95% CI: 0.80-5.45, P = .13, I 2 = 9%). Coronary artery bypass grafting has long-term benefits compared with PCI in patients with CAD and LV dysfunction.
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Zhang et al. (2016) conducted a meta-analysis in Coronary artery disease and left ventricular systolic dysfunction (n=6,082). Coronary artery bypass grafting (CABG) vs. Percutaneous coronary intervention (PCI) was evaluated on long-term death (OR 0.82, 95% CI 0.70-0.96, p=.01). Coronary artery bypass grafting was significantly associated with lower long-term death compared with PCI (OR 0.82; 95% CI 0.70-0.96; P=0.01) in patients with CAD and LV dysfunction.
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