Revascularization in severe ventricular dysfunction (15% ≤ LVEF ≤ 30%): a comparison of bypass grafting and percutaneous intervention

Toda, Köichi; MacKenzie, K.M.; Mehra, Mandeep R.; DiCorte, Charles J; Davis, James E.; McFadden, P. Michael; Ochsner, John L.; White, Christopher J.; Meter, Clifford H. Van

doi:10.1016/s0003-4975(02)04120-6

Cited by 43 publications

(39 citation statements)

References 14 publications

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“…In a subanalysis of secondary end points, we found significantly reduced risk for MI and RR in patients treated with CABG versus PCI. 20,[22][23][24][25]30,33,35 ; (B) repeat revascularization 20,22,23,25,28,33,35 ; and (C) stroke. 20 46 and subsequent metaanalyses 47 have suggested that intermediate-term mortality after interventional revascularization using modern stent systems is comparable to CABG, with a reduced risk of stroke but a higher need for RR.…”

Section: Discussionmentioning

confidence: 99%

“…20,22,23,25,28,30,33,35 There was a statistically significant reduction in RR with CABG compared with PCI treatment; the respective rates were 5. …”

Section: Repeat Revascularizationmentioning

confidence: 93%

“…Seven studies involving 2695 patients reported a prevalence of 3-vessel disease >50% in both groups ( Figure 4B). 18,[21][22][23]28,33 The overall incidence of all-cause mortality did not differ significantly between the 2 revascularization strategies: 27.85% (379 of 1361) among patients undergoing CABG and 30.51% (407 of 1334) among patients …”

Section: Cabg Versus Pci In Patients Stratified By Disease or Treatmementioning

confidence: 95%

“…10,15,16,[18][19][20][21][22][23][24]26,[29][30][31][32][33][34][35] For the remaining 5 articles, data were abstracted from the study summaries. 8,17,25,27,28 Patient baseline characteristics are shown in Table 2.…”

Section: Study Selection and Patient Populationsmentioning

confidence: 99%

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Survival Benefits of Invasive Versus Conservative Strategies in Heart Failure in Patients With Reduced Ejection Fraction and Coronary Artery Disease

Wolff

Dimitroulis

Andreotti

et al. 2017

Circ: Heart Failure

147

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Background— Heart failure with reduced ejection fraction caused by ischemic heart disease is associated with increased morbidity and mortality. It remains unclear whether revascularization by either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) carries benefits or risks in this group of stable patients compared with medical treatment. Methods and Results— We performed a meta-analysis of available studies comparing different methods of revascularization (PCI or CABG) against each other or medical treatment in patients with coronary artery disease and left ventricular ejection fraction ≤40%. The primary outcome was all-cause mortality; myocardial infarction, revascularization, and stroke were also analyzed. Twenty-one studies involving a total of 16 191 patients were included. Compared with medical treatment, there was a significant mortality reduction with CABG (hazard ratio, 0.66; 95% confidence interval, 0.61–0.72; P <0.001) and PCI (hazard ratio, 0.73; 95% confidence interval, 0.62–0.85; P <0.001). When compared with PCI, CABG still showed a survival benefit (hazard ratio, 0.82; 95% confidence interval, 0.75–0.90; P <0.001). Conclusions— The present meta-analysis indicates that revascularization strategies are superior to medical treatment in improving survival in patients with ischemic heart disease and reduced ejection fraction. Between the 2 revascularization strategies, CABG seems more favorable compared with PCI in this particular clinical setting.

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Section: Discussionmentioning

confidence: 99%

“…20,22,23,25,28,30,33,35 There was a statistically significant reduction in RR with CABG compared with PCI treatment; the respective rates were 5. …”

Section: Repeat Revascularizationmentioning

confidence: 93%

Section: Cabg Versus Pci In Patients Stratified By Disease or Treatmementioning

confidence: 95%

Section: Study Selection and Patient Populationsmentioning

confidence: 99%

See 2 more Smart Citations

Survival Benefits of Invasive Versus Conservative Strategies in Heart Failure in Patients With Reduced Ejection Fraction and Coronary Artery Disease

Wolff

Dimitroulis

Andreotti

et al. 2017

Circ: Heart Failure

147

View full text Add to dashboard Cite

show abstract

“…63 On the other hand, up to 50% of patients will demonstrate significant improvement in LVEF after CABG. 64 Improved survival in the immediate post-CABG period has not been demonstrated with the ICD. 65 There are even fewer data on ICD placement after PCI, but the issues of potential improvement in LVEF are similar.…”

Section: 52mentioning

confidence: 99%