Key result
CABG demonstrated a long-term survival advantage compared with PCI in patients with multi-vessel coronary artery disease (HR 0.77; 95% CI 0.75-0.79).
Why the study?
Does CABG improve long-term survival compared to PCI in patients with multi-vessel coronary artery disease?
Meta-Analysis (n=306,868)
Does CABG improve long-term survival compared to PCI in patients with multi-vessel coronary artery disease?
Effect estimate: HR 0.77 (95% CI 0.75-0.79)
In a pooled analysis of observational studies, CABG was associated with a significant long-term survival advantage over PCI in patients with multi-vessel coronary artery disease.
May inform CABG preference in multi-vessel CAD; leaves open randomized confirmation of survival benefit.
BACKGROUND: Several randomized controlled trials (RCT) have reported no difference in long-term mortality between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The purpose of this pooled observational analysis was to compare recent retrospective studies examining long-term survival of patients with multi-vessel coronary artery disease undergoing CABG and PCI. METHODOLOGY: We searched Medline for observational studies comparing long-term (>1 year) survival between CABG and PCI for the treatment of multi-vessel coronary artery disease over the past 10 years. RESULTS: Eight studies met inclusion criteria. A total of 306,868 patients (155,502 CABG; 151,366 PCI) were identified. Follow-up ranged from 1 to 8 years. Mantel-Haenszel combined hazard ratios (HR) for mortality demonstrated a protective benefit of CABG compared with PCI (HR=0.77, 95%CI=0.75-0.79). CONCLUSION: These findings suggest a long-term survival advantage for CABG compared with PCI in patients with multi-vessel coronary artery disease.
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Jimmy T. Efird (2013) conducted a meta-analysis in Multi-vessel coronary artery disease (n=306,868). CABG vs. PCI was evaluated on Long-term mortality (HR 0.77, 95% CI 0.75-0.79). CABG demonstrated a long-term survival advantage compared with PCI in patients with multi-vessel coronary artery disease (HR 0.77; 95% CI 0.75-0.79).