Comparative efficacy of eight therapeutic methods in the treatment of left main coronary artery disease: a Bayesian...

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Evidence-Based Medicine

Background:

• Direct comparative studies on minimally invasive versus traditional thoracotomy for coronary artery bypass grafting are numerous.
• However, a comprehensive ranking and summary of all surgical methods for left main coronary artery (LMCA) lesions are lacking.
• Existing views on LMCA disease treatment remain controversial.

Purpose of the Study:

• To conduct a planned network meta-analysis (NMA) comparing the long-term efficacy and safety of multiple therapeutic methods for LMCA disease.
• To provide a reference for selecting optimal clinical strategies for LMCA lesions.
• To address the current lack of ranked evidence for surgical interventions in LMCA disease.

Main Methods:

• A systematic literature search of PubMed, Embase, Web of Science, and The Cochrane Library from inception to June 2022.
• Inclusion of randomized controlled trials (RCTs) evaluating different surgical methods for LMCA disease.
• Bayesian network meta-analysis using STATA V.16.0, assessing methodological quality via the Cochrane risk of bias tool.

Main Results:

• Primary outcomes include major adverse cardiovascular events (mortality, myocardial infarction, stroke, revascularization).
• Secondary outcomes encompass operation-related time, blood transfusion, complications (e.g., atrial fibrillation, wound infection), functional scores, return to work, and costs.
• The NMA will provide a ranked comparison of surgical interventions for LMCA disease.

Conclusions:

• This study will synthesize evidence to rank surgical interventions for LMCA disease.
• The findings will inform clinical decision-making for treating LMCA lesions.
• A comprehensive comparison of efficacy and safety will be presented.