Coronary Artery Bypass Graft Surgery Improves Survival Without Increasing the Risk of Stroke in Patients with Ischemic Heart Failure in Comparison to Percutaneous Coronary Intervention: A Meta-Analysis With 54,173 Patients.

Autor:	Sá MPBO; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil.; Faculty of Medical Sciences and Biological Sciences Institute - FCM/ICB Nucleus of Postgraduate and Research in Health Sciences Recife Pernambuco Brazil Nucleus of Postgraduate and Research in Health Sciences, Faculty of Medical Sciences and Biological Sciences Institute - FCM/ICB, Recife, Pernambuco, Brazil., Perazzo ÁM; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Saragiotto FAS; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Cavalcanti LRP; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Almeida ACE Neto; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Campos JCS; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Braga PGB; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Rayol SDC; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Diniz RGS; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Sá FBCA; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil., Lima RC; Pronto Socorro Cardiológico de Pernambuco - PROCAPE Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, Pernambuco, Brazil.; University of Pernambuco - UPE Recife Pernambuco Brazil University of Pernambuco - UPE, Recife, Pernambuco, Brazil.; Faculty of Medical Sciences and Biological Sciences Institute - FCM/ICB Nucleus of Postgraduate and Research in Health Sciences Recife Pernambuco Brazil Nucleus of Postgraduate and Research in Health Sciences, Faculty of Medical Sciences and Biological Sciences Institute - FCM/ICB, Recife, Pernambuco, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2019 Aug 27; Vol. 34 (4), pp. 396-405. Date of Electronic Publication: 2019 Aug 27.
DOI:	10.21470/1678-9741-2019-0170
Abstrakt:	Objective: To evaluate whether there is any difference on the results of patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in the setting of ischemic heart failure (HF). Methods: Databases (MEDLINE, Embase, Cochrane Controlled Trials Register [CENTRAL/CCTR], ClinicalTrials.gov, Scientific Electronic Library Online [SciELO], Literatura Latino-americana e do Caribe em Ciências da Saúde [LILACS], and Google Scholar) were searched for studies published until February 2019. Main outcomes of interest were mortality, myocardial infarction, repeat revascularization, and stroke. Results: The search yielded 5,775 studies for inclusion. Of these, 20 articles were analyzed, and their data were extracted. The total number of patients included was 54,173, and those underwent CABG (N=29,075) or PCI (N=25098). The hazard ratios (HRs) for mortality (HR 0.763; 95% confidence interval [CI] 0.678-0.859; P<0.001), myocardial infarction (HR 0.481; 95% CI 0.365-0.633; P<0.001), and repeat revascularization (HR 0.321; 95% CI 0.241-0.428; P<0.001) were lower in the CABG group than in the PCI group. The HR for stroke showed no statistically significant difference between the groups (random effect model: HR 0.879; 95% CI 0.625-1.237; P=0.459). Conclusion: This meta-analysis found that CABG surgery remains the best option for patients with ischemic HF, without increase in the risk of stroke.
Databáze:	MEDLINE
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