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与冠状动脉搭桥手术及依维莫司洗脱支架经皮冠状动脉介入治疗相关的不良心血管结局:一项荟萃分析。

Adverse Cardiovascular Outcomes associated with Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention with Everolimus Eluting Stents: A Meta-Analysis.

作者信息

Bundhun Pravesh Kumar, Pursun Manish, Teeluck Abhishek Rishikesh, Bhurtu Akash, Soogund Mohammad Zafooruddin Sani, Huang Wei-Qiang

机构信息

Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530027, P. R. China.

Guangxi Medical University, Nanning, Guangxi, 530027, P. R. China.

出版信息

Sci Rep. 2016 Oct 24;6:35869. doi: 10.1038/srep35869.

Abstract

This study aimed to compare the mid-term adverse cardiovascular outcomes associated with Coronary Artery Bypass Surgery (CABG) and Percutaneous Coronary Intervention (PCI) with Everolimus Eluting Stents (EES). Electronic databases were searched for studies comparing the mid-term (>1 year) adverse cardiovascular outcomes between CABG and PCI with EES. Odd Ratios (OR) with 95% Confidence Intervals (CIs) were calculated and the pooled analyses were performed with RevMan 5.3 software. A total number of 5207 patients were involved in this analysis. No significant difference was observed in mortality between CABG and EES with OR: 0.90, 95% CI: 0.73-1.10; P = 0.30. Moreover, CABG was associated with a high stroke rate, with OR: 0.73, 95% CI: 0.45-1.17; P = 0.19, without any statistical significant. CABG was associated with significantly lower Major Adverse Cardiac Events and Myocardial Infarction with OR: 1.46, 95% CI: 1.05-2.04; P = 0.03 and OR: 1.46, 95% CI: 1.01-2.12; P = 0.05 respectively whereas PCI was associated with a significantly higher repeated revascularization with OR: 2.21; 95% CI: 1.76-2.77; P = 0.00001. In conclusion, significant differences were noted in several subgroups analyzing the mid-term cardiovascular outcomes between CABG and EES.

摘要

本研究旨在比较冠状动脉旁路移植术(CABG)和使用依维莫司洗脱支架(EES)的经皮冠状动脉介入治疗(PCI)的中期不良心血管结局。检索电子数据库,查找比较CABG与使用EES的PCI的中期(>1年)不良心血管结局的研究。计算比值比(OR)及95%置信区间(CI),并使用RevMan 5.3软件进行汇总分析。本分析共纳入5207例患者。CABG与EES在死亡率方面未观察到显著差异,OR为0.90,95%CI为0.73 - 1.10;P = 0.30。此外,CABG与较高的卒中发生率相关,OR为0.73,95%CI为0.45 - 1.17;P = 0.19,无统计学意义。CABG与显著更低的主要不良心脏事件和心肌梗死相关,OR分别为1.46,95%CI为1.05 - 2.04;P = 0.03以及OR为1.46,95%CI为1.01 - 2.12;P = 0.05,而PCI与显著更高的重复血运重建相关,OR为2.21;95%CI为1.76 - 2.77;P = 0.00001。总之,在分析CABG和EES中期心血管结局的几个亚组中发现了显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fe1/5075879/69a93e87ef66/srep35869-f1.jpg

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