Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study
Aims: The objective of this study is to compare the effectiveness and safety of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE-ACS). Methods: A literature search was conducted across...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2024-11-01
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| Series: | European Journal of Translational Myology |
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| Online Access: | https://www.pagepressjournals.org/bam/article/view/12930 |
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| author | Amirmohammad Khalifehsoltani Enwa Felix Oghenemaro Ahmed Hussein Zwamel Rekha M.M. Manish Srivastava Reza Akhavan-Sigari |
| author_facet | Amirmohammad Khalifehsoltani Enwa Felix Oghenemaro Ahmed Hussein Zwamel Rekha M.M. Manish Srivastava Reza Akhavan-Sigari |
| author_sort | Amirmohammad Khalifehsoltani |
| collection | DOAJ |
| description |
Aims: The objective of this study is to compare the effectiveness and safety of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE-ACS).
Methods: A literature search was conducted across PubMed, Scopus, and Web of Science, covering studies up to June 2024. Studies comparing PCI and CABG in patients with NSTE-ACS were included, focusing on clinical outcomes such as mortality, myocardial infarction (MI), cerebrovascular accidents (CVA), and the need for repeat revascularization. Data extraction and quality assessment were performed. Statistical analysis was conducted using R software, with the Mantel-Haenszel method and random-effects model employed to pool effect sizes and assess heterogeneity.
Results: A total of 15 studies met the eligibility criteria, including 48,891 patients. The pooled risk ratio (RR) for mortality showed no significant difference between PCI and CABG (RR = 1.09, 95% CI: 0.90-1.19, p = 0.28). CABG was associated with a significantly lower risk of subsequent MI (RR = 0.56, 95% CI: 0.38-0.61, p < 0.01) and the need for repeat revascularization (RR = 2.94, 95% CI: 2.30-3.76, p < 0.01). Conversely, PCI had a lower associated risk of CVA (RR = 0.58, 95% CI: 0.42-0.79, p < 0.01). High heterogeneity was observed in mortality outcomes, indicating variability among studies.
Conclusion: The findings suggest that while PCI and CABG have comparable mortality risks in NSTE-ACS patients, CABG offers superior protection against myocardial infarction and the need for repeat revascularization, whereas PCI is associated with a lower risk of cerebrovascular accidents. These results underscore the importance of individualized patient assessment in choosing the optimal revascularization strategy, considering patient-specific risk factors and clinical profiles.
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| format | Article |
| id | doaj-art-d22f3dec34b44edc846e5af2d53fa1cd |
| institution | Kabale University |
| issn | 2037-7452 2037-7460 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | European Journal of Translational Myology |
| spelling | doaj-art-d22f3dec34b44edc846e5af2d53fa1cd2024-11-29T08:16:30ZengPAGEPress PublicationsEuropean Journal of Translational Myology2037-74522037-74602024-11-0110.4081/ejtm.2024.12930Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis StudyAmirmohammad Khalifehsoltani0Enwa Felix Oghenemaro1Ahmed Hussein Zwamel2Rekha M.M.3Manish Srivastava4Reza Akhavan-Sigari5Islamic Azad University Medical Branch of Tehran, TehranDepartment of Pharmaceutical Microbiology, Faculty of Pharmacy, Abraka, Delta State UniversityMedical laboratory technique college, the Islamic University, Najaf, Iraq; Department of medical analysis, Medical laboratory technique college, the Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq; Department of medical analysis, Medical laboratory technique college, the Islamic University of Babylon, BabylonDepartment of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, KarnatakaDepartment of Endocrinology, National Institute of Medical Sciences, NIMS University Rajasthan, JaipurDreifaltigkeits-Hospital Lippstadt, Teaching Hospital of the University of Münster, Germany; Department of Health Care Management and Clinical Research, Collegium Humanum Warsaw Management University Warsaw Aims: The objective of this study is to compare the effectiveness and safety of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE-ACS). Methods: A literature search was conducted across PubMed, Scopus, and Web of Science, covering studies up to June 2024. Studies comparing PCI and CABG in patients with NSTE-ACS were included, focusing on clinical outcomes such as mortality, myocardial infarction (MI), cerebrovascular accidents (CVA), and the need for repeat revascularization. Data extraction and quality assessment were performed. Statistical analysis was conducted using R software, with the Mantel-Haenszel method and random-effects model employed to pool effect sizes and assess heterogeneity. Results: A total of 15 studies met the eligibility criteria, including 48,891 patients. The pooled risk ratio (RR) for mortality showed no significant difference between PCI and CABG (RR = 1.09, 95% CI: 0.90-1.19, p = 0.28). CABG was associated with a significantly lower risk of subsequent MI (RR = 0.56, 95% CI: 0.38-0.61, p < 0.01) and the need for repeat revascularization (RR = 2.94, 95% CI: 2.30-3.76, p < 0.01). Conversely, PCI had a lower associated risk of CVA (RR = 0.58, 95% CI: 0.42-0.79, p < 0.01). High heterogeneity was observed in mortality outcomes, indicating variability among studies. Conclusion: The findings suggest that while PCI and CABG have comparable mortality risks in NSTE-ACS patients, CABG offers superior protection against myocardial infarction and the need for repeat revascularization, whereas PCI is associated with a lower risk of cerebrovascular accidents. These results underscore the importance of individualized patient assessment in choosing the optimal revascularization strategy, considering patient-specific risk factors and clinical profiles. https://www.pagepressjournals.org/bam/article/view/12930Percutaneous coronary interventioncoronary artery bypass graftingnon-ST-segment elevation acute coronary syndrome |
| spellingShingle | Amirmohammad Khalifehsoltani Enwa Felix Oghenemaro Ahmed Hussein Zwamel Rekha M.M. Manish Srivastava Reza Akhavan-Sigari Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study European Journal of Translational Myology Percutaneous coronary intervention coronary artery bypass grafting non-ST-segment elevation acute coronary syndrome |
| title | Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study |
| title_full | Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study |
| title_fullStr | Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study |
| title_full_unstemmed | Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study |
| title_short | Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft in Treatment of Non-ST-segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis Study |
| title_sort | comparing percutaneous coronary intervention and coronary artery bypass graft in treatment of non st segment elevation acute coronary syndromes a systematic review and meta analysis study |
| topic | Percutaneous coronary intervention coronary artery bypass grafting non-ST-segment elevation acute coronary syndrome |
| url | https://www.pagepressjournals.org/bam/article/view/12930 |
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