A Meta-Analysis of Near-Long-Term Efficacy of Coronary Artery Bypass Grafting and Drug-Eluting Stent in Elderly Patients
Abstract: Objective: To evaluate the near-long-term efficacy of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in the elderly (age ≥ 75 years). Methods: We searched relevant literatures in MEDLINE (via pubmed), EMBASE, Cochrane Library from the time of building to 2017. Meanwhile, we collected conference records or gray literature from cardiovascular con-gresses to compare CABG and PCI for elderly patients. Meta analysis was performed using Review Manager 5.3 software. Results: A total of 12 articles were included in the meta-analysis, all of which were observational studies and randomized controlled studies (RCTs) were not retrieved. A total of 6877 patients were enrolled in this meta-analysis, of which 3460 (50.31%) were CABG. Meta- anal-ysis showed that the long-term mortality rate (OR = 1.29, 95% CI (1.07, 1.57), P = 0.009) and the in-cidence rate of revascularization (OR = 5.88, 95% CI (4.68, 7.38), P < 0.00001) have significant dif-ference between CABG group and PCI group. However, in-hospital mortality rate (OR = 0.78, 95% CI (0.56, 1.08), P = 0.14), the incidence rate of MACCE (OR = 1.01, 95% CI (0.88, 1.17), P = 0.87) and the incidence rate of MI (OR = 1.25, 95% CI (0.68, 2.30), P = 0.46) have not significant difference be-tween CABG group and PCI group. Conclusions: Compared with PCI, CABG can reduce the long-term mortality rate and the incidence rate of TLR in elderly patients, but more and more randomized controlled trials are still needed for further verification.
文章引用: 单龄童 , 王琪 , 肖雨洁 , 潘毅 , 魏枫 , 南明明 , 王俊 (2017) 高龄患者冠状动脉旁路移植术与置入药物洗脱支架术后近远期疗效比较的Meta分析。 外科， 6， 21-30. doi: 10.12677/HJS.2017.63004
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