Intriago Cesar, Escudero Cristopher-Josué, Endara-Mina Jesús, Dávila Oscar E, Zúñiga Miriam J, Loor Génesis D, Villamarín-Corrales José L, Gaibor Juan C, López-Carrera Rafael, Loya Luis S, Lema Angélica
Research, Larkin Community Hospital, South Miami, USA.
Research, Eugenio Espejo Specialties Hospital, Quito, ECU.
Cureus. 2024 Nov 20;16(11):e74068. doi: 10.7759/cureus.74068. eCollection 2024 Nov.
Coronary artery disease (CAD) is the leading cause of mortality in the United States, and percutaneous coronary intervention (PCI) is established as the standard after an acute episode of CAD. This review assessed the use of complete revascularization (CR) or incomplete revascularization (IR) in older adults, who present a higher cardiovascular risk. The aim is to define the effectiveness of both procedures in this population, focusing on major adverse cardiovascular events (MACE), myocardial infarction (MI), and all-cause mortality (ACM). A literature search identified 15 studies, evaluated using the Risk of Bias 2 (RoB 2) tool and the Risk of Bias in Non-Randomized Studies of Interventions I (ROBINS-I) tool for bias risk. Despite positive results in recent studies, this meta-analysis does not show the superiority of CR, demonstrating a lack of benefit in reducing mortality, myocardial infarction, and adverse events in the ≥ 70-year-old age group.
冠状动脉疾病（CAD）是美国的主要死因，经皮冠状动脉介入治疗（PCI）已成为CAD急性发作后的标准治疗方法。本综述评估了在心血管风险较高的老年人中使用完全血运重建（CR）或不完全血运重建（IR）的情况。目的是确定这两种手术在该人群中的有效性，重点关注主要不良心血管事件（MACE）、心肌梗死（MI）和全因死亡率（ACM）。文献检索确定了15项研究，使用偏倚风险2（RoB 2）工具和干预性非随机研究中的偏倚风险I（ROBINS-I）工具评估偏倚风险。尽管近期研究取得了积极成果，但这项荟萃分析并未显示CR的优越性，表明在≥70岁年龄组中，CR在降低死亡率、心肌梗死和不良事件方面缺乏益处。
