Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials
Identifieur interne : 006843 ( Main/Exploration ); précédent : 006842; suivant : 006844Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials
Auteurs : Giuseppe Ferrante [Italie] ; Patrizia Presbitero [Italie] ; Marco Valgimigli [Italie] ; Marie-Claude Morice [France] ; Paolo Pagnotta [Italie] ; Guido Belli [Italie] ; Elena Corrada [Italie] ; Yoshinobu Onuma [Pays-Bas] ; Peter Barlis [Australie] ; Didier Locca [Suisse] ; Eric Eeckhout [Suisse] ; Carlo Di Mario [Royaume-Uni] ; Patrick W. Serruys [Pays-Bas]Source :
- EuroIntervention [ 1774-024X ] ; 2011.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Aims: We performed a meta-analysis of randomised trials comparing percutaneous coronary intervention (PCI) with stent implantation to coronary artery bypass grafting (CABG) for the treatment of unprotected left main coronary artery stenosis (ULMCA). Methods and results: Pubmed and other databases were searched. Data were expressed as odds ratios (OR) with 95% confidence interval (CI). Four randomised trials enrolling 1,611 patients were selected. At 12-month follow-up PCI, as compared to CABG, was associated with a significant risk reduction of stroke (0.12% vs. 1.90%, OR 0.14, 95% CI [0.04 to 0.55], p=0.004), with an increased risk of repeat revascularisation (11.03% vs. 5.45%, OR 2.17, 95% CI [1.48 to 3.17], p <0.001), a similar risk of mortality (OR 0.72, 95% CI [0.42 to 1.24], p=0.23) or myocardial infarction (OR 0.97, 95% CI [0.54 to 1.74], p=0.91), leading to an increased risk of major adverse cardiovascular events (14.37% vs. 10.14%, OR 1.50, 95% CI [1.10 to 2.04], p=0.01) and similar hazard of major adverse cardiac or cerebrovascular events (14.49% vs. 12.04%, OR 1.24, 95% CI [0.93 to 1.67], p=0.15). Conclusions: PCI is comparable to CABG for the treatment of ULMCA with respect to the composite of major adverse cardiovascular or cerebrovascular events at 12-month follow-up.
Affiliations:
- Australie, France, Italie, Pays-Bas, Royaume-Uni, Suisse
- Angleterre, Canton de Vaud, Grand Londres, Hollande-Méridionale, Lombardie
- Lausanne, Londres, Milan, Rotterdam
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Anna, University of Ferrara</s1><s2>Ferrara</s2><s3>ITA</s3><sZ>3 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Ferrara</wicri:noRegion></affiliation></author><author><name sortKey="Morice, Marie Claude" sort="Morice, Marie Claude" uniqKey="Morice M" first="Marie-Claude" last="Morice">Marie-Claude Morice</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Cartier</s1><s2>Massy</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Massy</wicri:noRegion><wicri:noRegion>Institut Hospitalier Jacques Cartier</wicri:noRegion><wicri:noRegion>Massy</wicri:noRegion></affiliation></author><author><name sortKey="Pagnotta, Paolo" sort="Pagnotta, Paolo" uniqKey="Pagnotta P" first="Paolo" last="Pagnotta">Paolo Pagnotta</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Interventional Cardiology, Istituto clinico Humanitas IRCCS, Rozzano</s1><s2>Milan</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Belli, Guido" sort="Belli, Guido" uniqKey="Belli G" first="Guido" last="Belli">Guido Belli</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Interventional Cardiology, Istituto clinico Humanitas IRCCS, Rozzano</s1><s2>Milan</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Corrada, Elena" sort="Corrada, Elena" uniqKey="Corrada E" first="Elena" last="Corrada">Elena Corrada</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Interventional Cardiology, Istituto clinico Humanitas IRCCS, Rozzano</s1><s2>Milan</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Onuma, Yoshinobu" sort="Onuma, Yoshinobu" uniqKey="Onuma Y" first="Yoshinobu" last="Onuma">Yoshinobu Onuma</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Cardiology, Erasmus Medical Center, Thoraxcentrum</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>8 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Barlis, Peter" sort="Barlis, Peter" uniqKey="Barlis P" first="Peter" last="Barlis">Peter Barlis</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Cardiology, The Northern Hospital</s1><s2>Victoria</s2><s3>AUS</s3><sZ>9 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Victoria</wicri:noRegion></affiliation></author><author><name sortKey="Locca, Didier" sort="Locca, Didier" uniqKey="Locca D" first="Didier" last="Locca">Didier Locca</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Cardiology, University Hospital</s1><s2>Lausanne</s2><s3>CHE</s3><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Eeckhout, Eric" sort="Eeckhout, Eric" uniqKey="Eeckhout E" first="Eric" last="Eeckhout">Eric Eeckhout</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Cardiology, University Hospital</s1><s2>Lausanne</s2><s3>CHE</s3><sZ>10 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Di Mario, Carlo" sort="Di Mario, Carlo" uniqKey="Di Mario C" first="Carlo" last="Di Mario">Carlo Di Mario</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Cardiovascular Department, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College</s1><s2>London</s2><s3>GBR</s3><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Serruys, Patrick W" sort="Serruys, Patrick W" uniqKey="Serruys P" first="Patrick W." last="Serruys">Patrick W. Serruys</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Cardiology, Erasmus Medical Center, Thoraxcentrum</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>8 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author></analytic><series><title level="j" type="main">EuroIntervention</title><title level="j" type="abbreviated">EuroIntervention</title><idno type="ISSN">1774-024X</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">EuroIntervention</title><title level="j" type="abbreviated">EuroIntervention</title><idno type="ISSN">1774-024X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Analysis</term><term>Angioplasty</term><term>Atherectomy</term><term>Comparative study</term><term>Coronary artery</term><term>Coronary artery bypass</term><term>Coronary heart disease</term><term>Graft</term><term>Instrumentation therapy</term><term>Left coronary artery</term><term>Percutaneous route</term><term>Stent</term><term>Surgical anastomosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cardiopathie coronaire</term><term>Angioplastie</term><term>Artère coronaire</term><term>Athérectomie</term><term>Stent</term><term>Voie percutanée</term><term>Etude comparative</term><term>Anastomose chirurgicale</term><term>Artère coronaire gauche</term><term>Analyse</term><term>Greffe</term><term>Traitement instrumental</term><term>Pontage coronarien</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aims: We performed a meta-analysis of randomised trials comparing percutaneous coronary intervention (PCI) with stent implantation to coronary artery bypass grafting (CABG) for the treatment of unprotected left main coronary artery stenosis (ULMCA). Methods and results: Pubmed and other databases were searched. Data were expressed as odds ratios (OR) with 95% confidence interval (CI). Four randomised trials enrolling 1,611 patients were selected. At 12-month follow-up PCI, as compared to CABG, was associated with a significant risk reduction of stroke (0.12% vs. 1.90%, OR 0.14, 95% CI [0.04 to 0.55], p=0.004), with an increased risk of repeat revascularisation (11.03% vs. 5.45%, OR 2.17, 95% CI [1.48 to 3.17], p <0.001), a similar risk of mortality (OR 0.72, 95% CI [0.42 to 1.24], p=0.23) or myocardial infarction (OR 0.97, 95% CI [0.54 to 1.74], p=0.91), leading to an increased risk of major adverse cardiovascular events (14.37% vs. 10.14%, OR 1.50, 95% CI [1.10 to 2.04], p=0.01) and similar hazard of major adverse cardiac or cerebrovascular events (14.49% vs. 12.04%, OR 1.24, 95% CI [0.93 to 1.67], p=0.15). Conclusions: PCI is comparable to CABG for the treatment of ULMCA with respect to the composite of major adverse cardiovascular or cerebrovascular events at 12-month follow-up.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suisse</li></country><region><li>Angleterre</li><li>Canton de Vaud</li><li>Grand Londres</li><li>Hollande-Méridionale</li><li>Lombardie</li></region><settlement><li>Lausanne</li><li>Londres</li><li>Milan</li><li>Rotterdam</li></settlement></list><tree><country name="Italie"><region name="Lombardie"><name sortKey="Ferrante, Giuseppe" sort="Ferrante, Giuseppe" uniqKey="Ferrante G" first="Giuseppe" last="Ferrante">Giuseppe Ferrante</name></region><name sortKey="Belli, Guido" sort="Belli, Guido" uniqKey="Belli G" first="Guido" last="Belli">Guido Belli</name><name sortKey="Corrada, Elena" sort="Corrada, Elena" uniqKey="Corrada E" first="Elena" last="Corrada">Elena Corrada</name><name sortKey="Pagnotta, Paolo" sort="Pagnotta, Paolo" uniqKey="Pagnotta P" first="Paolo" last="Pagnotta">Paolo Pagnotta</name><name sortKey="Presbitero, Patrizia" sort="Presbitero, Patrizia" uniqKey="Presbitero P" first="Patrizia" last="Presbitero">Patrizia Presbitero</name><name sortKey="Valgimigli, Marco" sort="Valgimigli, Marco" uniqKey="Valgimigli M" first="Marco" last="Valgimigli">Marco Valgimigli</name></country><country name="France"><noRegion><name sortKey="Morice, Marie Claude" sort="Morice, Marie Claude" uniqKey="Morice M" first="Marie-Claude" last="Morice">Marie-Claude Morice</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Onuma, Yoshinobu" sort="Onuma, Yoshinobu" uniqKey="Onuma Y" first="Yoshinobu" last="Onuma">Yoshinobu Onuma</name></region><name sortKey="Serruys, Patrick W" sort="Serruys, Patrick W" uniqKey="Serruys P" first="Patrick W." last="Serruys">Patrick W. Serruys</name></country><country name="Australie"><noRegion><name sortKey="Barlis, Peter" sort="Barlis, Peter" uniqKey="Barlis P" first="Peter" last="Barlis">Peter Barlis</name></noRegion></country><country name="Suisse"><region name="Canton de Vaud"><name sortKey="Locca, Didier" sort="Locca, Didier" uniqKey="Locca D" first="Didier" last="Locca">Didier Locca</name></region><name sortKey="Eeckhout, Eric" sort="Eeckhout, Eric" uniqKey="Eeckhout E" first="Eric" last="Eeckhout">Eric Eeckhout</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Di Mario, Carlo" sort="Di Mario, Carlo" uniqKey="Di Mario C" first="Carlo" last="Di Mario">Carlo Di Mario</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials
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