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Complete revascularization reduces adverse outcomes in patients with multivessel coronary artery disease

Complete revascularization reduces adverse outcomes in patients with multivessel coronary artery disease
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摘要 AIM To investigate the infuence of complete and incomplete revascularization (ICR) in patients with multivessel coro-nary artery disease undergoing coronary artery bypass or percutaneous coronary intervention.METHODS We searched PubMed using the keywords “complete revascularization”, “incomplete revascularization”, “cor-onary artery bypass”, and “percutaneous coronary intervention”. We selected randomized controlled studies (RCT) and observational studies only for review. The main outcomes of interest were mortality, myocardial infarction (MI) and repeat revascularization. We identified further studies by hand searching relevant publications and included those that met with the inclusion criteria in our fnal analysis and performed a systematic review.RESULTSTen studies were identified, including 13327 patients of whom, 8053 received complete revascularization and 5274 received ICR. Relative to ICR, CR was associated with lower mortality (RR: 0.755, 95%CI: 0.66 to 0.864, P = 0.765, I2 = 0.0%), lower rates of MI (RR: 0.759, 95%CI: 0.615 to 0.937, P = 0.091, I2 = 45.1%), lower rates of MACCE (RR: 0.731, 95%CI: 0.668 to 0.8, P = 0.453, I2 = 0.0%) and reduced rates of repeat coronary revascularization (RR: 0.691, 95%CI: 0.541 to 0.883, P = 0.0, I2 = 88.3%).CONCLUSIONCR is associated with lower rates of adverse outcomes. CR can be used as a standard in the choice of any particular revascularization strategy. AIM To investigate the influence of complete and incomplete revascularization(ICR) in patients with multivessel coronary artery disease undergoing coronary artery bypass or percutaneous coronary intervention.METHODS We searched Pub Med using the keywords "complete revascularization","incomplete revascularization","coronary artery bypass",and "percutaneous coronary intervention". We selected randomized controlled studies(RCT) and observational studies only for review. The main outcomes of interest were mortality,myocardial infarction(MI) and repeat revascularization. We identified further studies by hand searching relevant publications and included those that met with the inclusion criteria in our final analysis and performed a systematic review. RESULTS Ten studies were identified,including 13327 patients of whom,8053 received complete revascularization and 5274 received ICR. Relative to ICR,CR was associated with lower mortality(RR: 0.755,95%CI: 0.66 to 0.864,P = 0.765,I^2 = 0.0%),lower rates of MI(RR: 0.759,95%CI: 0.615 to 0.937,P = 0.091,I^2 = 45.1%),lower rates of MACCE(RR: 0.731,95%CI: 0.668 to 0.8,P = 0.453,I^2 = 0.0%) and reduced rates of repeat coronary revascularization(RR: 0.691,95%CI: 0.541 to 0.883,P = 0.0,I^2 = 88.3%).CONCLUSION CR is associated with lower rates of adverse outcomes. CR can be used as a standard in the choice of any particular revascularization strategy.
出处 《World Journal of Meta-Analysis》 2017年第6期167-176,共10页 世界荟萃分析杂志
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