Dataset Information


Effect of increasing age on percutaneous coronary intervention vs coronary artery bypass grafting in older adults with unprotected left main coronary artery disease: A meta-analysis and meta-regression.

ABSTRACT: BACKGROUND:Older adults (?70-year-old) are under-represented in the published data pertaining to unprotected left main coronary artery disease (ULMCAD). HYPOTHESIS:Percutaneous coronary intervention (PCI) might be comparable to coronary artery bypass grafting (CABG) for revascularization of ULMCAD. METHODS:We compared PCI versus CABG in older adults with ULMCAD with an aggregate data meta-analyses (4880 patients) of clinical outcomes [all-cause mortality, myocardial infarction (MI), repeat revascularization, stroke and major adverse cardiac and cerebrovascular events(MACCE)] at 30 days, 12-24 months & ?36 months in patients with mean age ?70 years and ULMCAD. A meta-regression analysis evaluated the effect of age on mortality after PCI. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using random-effects model. RESULTS:All-cause mortality between PCI and CABG was comparable at 30-days (OR0.77, 95% CI 0.42- 1.41) and 12-24-months (OR 1.22, 95% CI 0.78-1.93). PCI was associated with a markedly lower rate of stroke at 30-day follow-up in octogenarians (OR 0.14, 95% CI 0.02-0.76) but an overall higher rate of repeat revascularization. At ?36-months, MACCE (OR 1.26,95% CI 0.99-1.60) and all-cause mortality (OR 1.39, 95% CI 1.00-1.93) showed a trend favoring CABG but did not reach statistical significance. On meta-regression, PCI was associated with a higher mortality with advancing age (coefficient=0.1033, p=0.042). CONCLUSIONS:PCI was associated with a markedly lower rate of early stroke in octogenarians as compared to CABG. All-cause mortality was comparable between the two arms with a trend favoring CABG at ?36-months.PCI was however associated with increasing mortality with advancing age as compared to CABG.


PROVIDER: S-EPMC6837018 | BioStudies | 2019-01-01

REPOSITORIES: biostudies

Similar Datasets

2017-01-01 | S-EPMC5730452 | BioStudies
2020-01-01 | S-EPMC7399756 | BioStudies
2017-01-01 | S-EPMC5662302 | BioStudies
1000-01-01 | S-EPMC5839846 | BioStudies
2015-01-01 | S-EPMC4944845 | BioStudies
2020-01-01 | S-EPMC7557472 | BioStudies
2014-01-01 | S-EPMC4262069 | BioStudies
1000-01-01 | S-EPMC5940397 | BioStudies
2013-01-01 | S-EPMC3816637 | BioStudies
2016-01-01 | S-EPMC4718717 | BioStudies