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Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention in Patients With Left Ventricular Systolic

Dongfeng Zhang1, Shuzheng Lyu2, Xiantao Song2

  • 1Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Angiology
|April 13, 2016
PubMed

Insights

For patients with coronary artery disease and left ventricular systolic dysfunction, coronary artery bypass grafting (CABG) shows long-term benefits over percutaneous coronary intervention (PCI). CABG significantly reduces long-term death, myocardial infarction, and repeat revascularization.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Optimal coronary revascularization strategy for patients with coronary artery disease (CAD) and left ventricular (LV) systolic dysfunction remains debated.
  • Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are primary revascularization methods.

Purpose of the Study:

  • To compare the efficacy and safety of CABG versus PCI in patients with CAD and LV systolic dysfunction.
  • To evaluate long-term outcomes including mortality, myocardial infarction, and need for repeat revascularization.

Main Methods:

  • A systematic meta-analysis was conducted.
  • Searched PubMed, EMBASE, and Cochrane Controlled Trials Register for relevant studies.
  • Included 4 prospective and 5 retrospective studies involving 6082 patients published before March 2015.

Main Results:

  • CABG was associated with significantly lower long-term death (OR: 0.82, P = .01) compared to PCI.
  • CABG demonstrated significantly lower rates of myocardial infarction (OR: 0.58, P = .03) and repeat revascularization (OR: 0.17, P < .001).
  • Short-term mortality rates were comparable between CABG and PCI (OR: 2.09, P = .13).

Conclusions:

  • Coronary artery bypass grafting offers significant long-term survival and clinical benefits over percutaneous coronary intervention in patients with CAD and LV systolic dysfunction.
  • CABG is a preferred revascularization strategy for this patient population, considering long-term outcomes.

Keywords:
coronary artery bypass graftingcoronary artery diseaseleft ventricular systolic dysfunctionpercutaneous coronary intervention

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