Universität zu Köln

Deppe, Antje-Christin, Liakopoulos, Oliver J., Kuhn, Elmar W., Slottosch, Ingo, Scherner, Maximilian, Choi, Yeong-Hoon, Rahmanian, Parwis B. ORCID: 0000-0002-3978-9251 and Wahlers, Thorsten (2015). Minimally invasive direct coronary bypass grafting versus percutaneous coronary intervention for single-vessel disease: a meta-analysis of 2885 patients. Eur. J. Cardio-Thorac. Surg., 47 (3). S. 397 - 407. CARY: OXFORD UNIV PRESS INC. ISSN 1873-734X

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Abstract

Percutaneous coronary intervention (PCI) and minimally invasive direct coronary artery bypass (MIDCAB) grafting are both established therapeutic options for single-vessel disease of the left anterior descending artery (LAD). The present systematic review with meta-analysis aims to determine the current strength of evidence for or against PCI and MIDCAB for revascularization of the LAD. Therefore, we performed a meta-analysis of randomized, controlled trials (RCTs) and observational trials (OTs) that reported clinical outcome after isolated LAD revascularization. Analysed postoperative outcomes included major adverse cardiac and cerebrovascular events (MACCEs), all-cause mortality, myocardial infarction and stroke. Pooled treatment effects [odds ratio (OR) or weighted mean difference (WMD), 95% confidence intervals (95% CI)] were assessed using a fixed-or random-effects model. A total of 2885 patients from 12 studies (6 RCTs, 6 OTs) were identified after a literature search of major databases using a predefined list of keywords. PCI of the LAD was performed in 60.7% (n = 1751) and MIDCAB in 39.3% of patients (n = 1126). Pooled-effect estimates revealed an increased incidence for MACCEs after PCI (OR 1.98; 95% CI 1.45-2.69; P < 0.0001) 6 months after the procedure. Especially, PCI was particularly associated with an increased odds for target vessel revascularization (OR 2.11; 95% CI 1.00-4.47; P = 0.0295). No differences with regard to stroke, myocardial infarction and all-cause mortality were observed between both revascularization strategies. Patients after PCI had a shorter length of hospital stay (WMD -3.37 days; 95% CI (-) 4.92 to (-) 1.81; P < 0.0001). In conclusion, the present systematic review underscores the superiority of MIDCAB over PCI for treatment of single-vessel disease of the LAD.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Deppe, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis B. UNSPECIFIED orcid.org/0000-0002-3978-9251 UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-411667
DOI:	10.1093/ejcts/ezu285
Journal or Publication Title:	Eur. J. Cardio-Thorac. Surg.
Volume:	47
Number:	3
Page Range:	S. 397 - 407
Date:	2015
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1873-734X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DRUG-ELUTING STENTS; ANTERIOR DESCENDING ARTERY; HIGH-GRADE STENOSIS; FOLLOW-UP; OFF-PUMP; SURGERY; REVASCULARIZATION; MIDCAB; IMPLANTATION; ANGIOPLASTY Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41166