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Preferred Revascularization Strategies in Patients with Ischemic Heart Failure: A Meta-Analysis

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Abstract

Clinically, coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is generally used to treat patients with ischemic heart failure. However, the optimal treatment strategy remains unknown. This study examined the efficacy of the two coronary revascularization strategies for severe ischemic heart failure by using a meta-analysis. Studies comparing the efficacy of CABG and PCI were obtained from PubMed, EMBASE, Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL). The quality of each eligible article was evaluated by Newcastle-Ottawa Quality Assessment Scale (NOS), and the meta-analysis was performed using Stata version 12.0 software. Eventually, 12 studies involving 9248 patients (n=4872 in CABG group; n=4376 in PCI group) were subject to the meta-analysis for subsequent pooling calculation. The pooled hazard ratio (HR) [HR=0.83, 95% CI (0.76, 0.90), P<0.001; heterogeneity, P=0.218, I2=22.9%] of CABG compared with that of PCI revealed a statistical superiority of CABG to PCI in terms of the long-term mortality. Furthermore, CABG showed more advantages over PCI with respect to the incidence of myocardial infarction [HR=0.51, 95% CI (0.39, 0.67), P<0.001; heterogeneity, P=0.707, I2=0%] and repeat revascularization [HR=0.40, 95% CI (0.27, 0.59), P<0.001; heterogeneity, P<0.001, I2=80.1%]. It was concluded that CABG appears to be more advantageous than PCI for the treatment of ischemic heart failure in the given clinical setting.

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Author notes

  1. Both authors contributed equally to this work

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jie Xiao, Fen Xu, Wei-qiang Chen, Xing Chen, Hua Zhang & Jin-ping Liu

  2. Department of Cardio-Thoracic Surgery, Ganzhou People’s Hospital, Ganzhou, 341000, China

    Jie Xiao

  3. Department of Cardiovascular Surgery, Central Hospital of Wuhan, Wuhan, 430022, China

    Chuan-lei Yang

  4. Department of Thyroid Surgery, Central Hospital of Wuhan, Wuhan, 430022, China

    Zhan-jie Wei

Authors
  1. Jie Xiao
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  2. Fen Xu
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  3. Chuan-lei Yang
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  4. Wei-qiang Chen
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  5. Xing Chen
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  6. Hua Zhang
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Corresponding author

Correspondence to Jin-ping Liu.

Additional information

This meta-analysis was supported by National Natural Science Foundation of China (No. 81570427 and No. 81270322).

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Xiao, J., Xu, F., Yang, Cl. et al. Preferred Revascularization Strategies in Patients with Ischemic Heart Failure: A Meta-Analysis. CURR MED SCI 38, 776–784 (2018). https://doi.org/10.1007/s11596-018-1944-8

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  • DOI: https://doi.org/10.1007/s11596-018-1944-8

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