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Mortality After Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention With Stenting for Coronary Artery Disease: A Pooled Analysis of Individual Patient Data

Friday, February 23, 2018

Submitted by

Ruben Osnabrugge

Source

Source Name: The Lancet

Source URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30423-9/fullte…

Author(s)

Stuart J Head, Milan Milojevic, Joost Daemen, Jung-Min Ahn, Eric Boersma, Evald H Christiansen, Michael J Domanski, Michael E Farkouh, Marcus Flather, Valentin Fuster, Mark A Hlatky, Niels R Holm, Whady A Hueb, Masoor Kamalesh, Young-Hak Kim, Timo Mäkikallio, Friedrich W Mohr, Grigorios Papageorgiou, Seung-Jung Park, Alfredo E Rodriguez, Joseph F Sabik 3rd, Rodney H Stables, Gregg W Stone, Patrick W Serruys, Arie Pieter Kappetein

In this patient level meta-analysis of 11 randomised trials, the authors compare PCI using stents with CABG. In total, almost 12,000 randomised patients were included.

They found that at a mean of 3.8 years of follow-up, mortality was higher after PCI versus CABG (11.2% versus 9.2%, hazard ratio 1.20, 95% confidence interval 1.06 - 1.37, p = 0.0038). The vast amount of data allowed meaningful analysis of subgroups. The mortality benefit was particularly clear in patients with multivessel disease and diabetes, whereas there was no difference between the two treatments in patients with left main disease or without diabetes.