Comparison of Off-pump Coronary Artery Bypass Grafting With Percutaneous Coronary Intervention Versus Drug-Eluting Stents for Three-Vessel Coronary Artery Disease

Yi, Gijong; Youn, Young‐Nam; Yoo, Kyung-Jong; Hong, Young Ho

doi:10.1016/j.athoracsur.2008.07.040

Cited by 14 publications

(18 citation statements)

References 25 publications

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“…17 In patients with severe atherosclerosis of the cervical and cranial vessels, inflammation can trigger delayed plaque rupture or platelet aggregation with consequent embolism. 21,22 Late stroke, however, seems to be equally distributed between the 2 strategies during follow-up. The reasons are unclear for late stroke after CABG or PCI added to traditional risk factors.…”

Section: Discussionmentioning

confidence: 99%

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Athappan

Chacko

Patvardhan

et al. 2014

Stroke

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Background and Purpose-Studies have suggested that the early excess risk of stroke in coronary artery bypass grafting (CABG) may be compensated for by a slow but progressive catch-up phenomenon in patients undergoing percutaneous coronary intervention (PCI). We therefore undertook this analysis to compare the temporal stroke risk between PCI and CABG in patients with unprotected left main stenosis and multivessel coronary artery disease. Methods-Studies of PCI versus CABG for unprotected left main stenosis and multivessel disease published between January 1994 (stent era) and July 2013 were identified using an electronic search and reviewed using meta-analytic techniques. Results-We selected 57 reports for the meta-analysis by applying the inclusion and exclusion criteria. The primary search terms used were CABG and PCI. For the Cochrane database the search terms were limited by the term clinical trial. Limiting the search parameters to the English language was applied subsequently. Citations were screened at the title and abstract level and retrieved as full reports if they were clinical studies, compared PCI with CABG, and provided information on the outcome of stroke. The full texts of all potential articles were reviewed in detail. The bibliography of retained studies was used to seek additional relevant studies. Inclusion CriteriaStudies were included if the following criteria applied: (1) comparative trials of CABG versus PCI with stent placement, (2) unprotected left main stenosis of >50% narrowing or multivessel disease, (3) a minimum of 30 patients, and (4) a minimum follow-up of 1 year. When 2 similar studies were reported from the same institution or author, the most recent publication was included in the analysis. Exclusion CriteriaStudies were excluded if any of the following criteria applied: (1) outcome of interest was not clearly reported or was impossible to extract or calculate from the published results, (2) <1-year follow-up, (3) included patients with ST-segment-elevation myocardial infarction, and (4) included patients with percutaneous transluminal coronary angioplasty without stents. Data ExtractionInformation collected included first author, year and journal of publication, study design, inclusion/exclusion criteria, definition of primary and secondary end points, number of subjects included, subjects undergoing PCI and CABG, percentage of drug-eluting stent used, study population demographics, number of diseased vessels, stenting technique, type of CABG (on pump versus off pump), left internal mammary artery graft used (single versus double), follow-up time period, rates of angiographic follow-up, antiplatelet regimen used, and primary and secondary outcomes. There was no disagreement between the 2 reviewers (G.A. and P.C.).

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Section: Discussionmentioning

confidence: 99%

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Athappan

Chacko

Patvardhan

et al. 2014

Stroke

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“…In some studied included in the present meta-analysis, a significantly higher proportion of patients had complete revascularization in CABG than after DES [3,4,6,7,13]. The number of revascularization vessels was also significantly greater in the CABG than DES group [6,7,13]. Further, the number of distal anastomoses in the CABG group was somewhat greater than the number of stents (including bare metal stents [BMS]) implanted in the DES group [6,7,11].…”

Section: Contents Lists Available At Sciverse Sciencedirectmentioning

confidence: 59%

Section: Contents Lists Available At Sciverse Sciencedirectmentioning

confidence: 74%

“…The number of revascularization vessels was also significantly greater in the CABG than DES group [6,7,13]. Further, the number of distal anastomoses in the CABG group was somewhat greater than the number of stents (including bare metal stents [BMS]) implanted in the DES group [6,7,11]. In patients with MVD, complete revascularization (CR) with PCI may be associated with better outcomes than incomplete revascularization (IR).…”

Section: Contents Lists Available At Sciverse Sciencedirectmentioning

confidence: 91%

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Drug-eluting stents increase late mortality compared with coronary artery bypass grafting in triple-vessel disease: A meta-analysis of randomized controlled and risk-adjusted observational studies

Takagi

Yamamoto

Iwata

et al. 2012

International Journal of Cardiology

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“…In the comment letter [2], the authors proposed that our cumulative rate of all-cause death at 3 years from only 3 nonrandomized observational cohort studies [3][4][5] (enrolling a total of 2417 patients) was lower in the off-pump coronary bypass grafting (OPCAB) group than the drug-eluting stent (DES) group (relative risk (RR), 0.56; 95% confidence interval (CI), 0.33 to 0.96; P = 0.03) [1], which seemed discrepant from their results that OPCAB was not associated with improved survival during ≧1 year (range from 1 to 5.5 years) follow-up over DES (hazard ratio (HR), 0.72; 95% CI, 0.45 to 1.17; P = 0.19) in their recent metaanalysis [6]. It was pointed out by the authors that our results were vulnerable to bias because of the crude data extracted from observational studies without any adjustment for significant differences in the baseline characteristics of patients.…”

mentioning

confidence: 99%

Response to the comment letter about adjustment

Zhuang

Wang

2014

International Journal of Cardiology

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Comparison of Off-pump Coronary Artery Bypass Grafting With Percutaneous Coronary Intervention Versus Drug-Eluting Stents for Three-Vessel Coronary Artery Disease

Cited by 14 publications

References 25 publications

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Drug-eluting stents increase late mortality compared with coronary artery bypass grafting in triple-vessel disease: A meta-analysis of randomized controlled and risk-adjusted observational studies

Response to the comment letter about adjustment

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