Author + information
- Olga Bockeriya,
- Zalina Kudzoeva and
- Soslan Khugaev
Background: Previous meta-analysis of coronary artery bypass grafting (CABG) versus percutaneous coronary interventions (PCI) have shown higher incidence of stroke for CABG during different follow-up periods and similar results or prevalence of CABG for late outcomes. New data on long-term results from numerous randomized trials appears in literature over time. “Time-to-event” analysis was not previously used to avoid potential data bias in long-term (5 years and more) follow-up.
Aim: To perform “time-to-event” meta-analysis for CABG versus PCI with drug eluting stents (DES) during 5-year follow-up in multivessel disease patient group.
Materials and Methods: We included 8 randomized trials (5499 patients in total) comparing CABG versus PCI with DES. End-points were: repeat revascularization, death, MI and stroke. We performed time-to-event analysis for the end-points results between two follow-up periods: 12 and 13-60 months. Statistical analysis was performed using Comprehensive Meta-Analysis V.2.0. For dichotomous outcomes odds ratio (OR) and 95% confidence interval (CI) were calculated.
Results: At 12 months follow-up MI and death rates were similar (OR 1.012, CI 0.692-1.483, p =0.951 and OR 1.060, CI 0.731-1.538, p =0.758); CABG had lower repeat revascularization rate (OR = 0.745; 95% CI 0.647–0.858, p = 0.000) and higher stroke (OR = 1.040; 95% CI 0.646–1.675, p = 0.870). In 13-60 month follow-up – CABG had better survival, MI and repeat revascularization rate (OR 0.736, CI 0.460-1.179, p = 0.202; OR 0.312, CI 0.115-0.849, p =0.022; OR = 0.491; 95% CI: [0.365–0.659]; p = 0.000) and no differences in stroke (OR 1.055, CI 0.776-2.368, p=0.022) comparing to PCI.
Conclusions: Time-to-event analysis is a new tool for detailed evaluation of the events in long-term follow-up. It provides more accurate results and strengthens the evidence base. In this meta-analysis we found the CABG prevalence in all end-points after the 1st year in multivessel disease. Stroke risk was similar at this time of follow-up.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Revascularization and Myocardial Preservation in Acute and Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1165-305
- 2017 American College of Cardiology Foundation