Abstract

JACC

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TCTAP A-017

Presenter

Jianfeng Zheng

Authors

Jianfeng Zheng1, JiLin Zheng1, Xiaoying Lou2

Affiliation

Fuwai Hospital, China1, Cancer Hospital, China2
View Study Report
TCTAP A-017
Bifurcation/Left Main Diseases and Intervention

Long-term Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Surgery in Elderly Patients with Multivessel and/or Left Main Coronary Artery Disease and Diabetes Mellitus: A Systematic Review and Meta-analysis

Jianfeng Zheng1, JiLin Zheng1, Xiaoying Lou2

Fuwai Hospital, China1, Cancer Hospital, China2

Background

This meta-analysis was performed to compare two methods of superior revascularization strategies coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with multivessel and/or left main coronary artery disease for elderly patients diabetes mellitus.

Methods

An electronic search of recent studies (2009–2019) was carried out using ¡°diabetes mellitus¡±, ¡°coronary artery bypass surgery¡±, and ¡°percutaneous coronary intervention¡± as the main search terms. Stata software (version 15.0) was used to calculate relative risk (RR) and 95% confidence intervals (CIs). 

Results

Among those observational studies, PCI and CABG patients did not differ significantly in their rates of stroke/cerebrovascular events(CVE)/cerebrovascular accident(CVA) (RR 0.98 95% CI 0.87-1.10;P=0.697 ) and cardiac death (RR 1.22 95% CI 0.95-1.57;P=0.118 ). However, rates of major adverse of cardiac and cerebral events(MACCEs), all-cause death, myocardial infraction(MI) and any repeat revascularization were significantly higher in the PCI group. Although there was no significant difference of MI (RR 1.26 95% CI 0.90-1.77;P=0.173) and stroke/CVE/CVA (RR 0.52 95% CI 0.26-1.03;P=0.061) among those RCT studies, the CABG significantly had lower all-cause death, cardiac death and any repeat revascularization.

Conclusion

Despite the high potential risk of stroke/CVE/CVA, CABG was better than PCI for diabetic elderly patients with multivessel and/or left main coronary artery disease  in clinical practice.