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Long-term outcomes with drug-eluting stents or coronary artery bypass surgery for unprotected left main coronary disease: A meta-analysis and trial sequential of randomized trials
Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has emerged as an acceptable revascularization strategy for select patients with unprotected left main coronary disease (LMCA).1 The EXCEL trial showed no difference between DES and coronary artery bypass surgery (CABG) at 5 years for the composite of death, procedure and non-procedure related myocardial infarction (MI), or stroke,2 however; all-cause mortality was higher with DES at 5 years, which was a secondary end-point.
Source: The American Journal of Cardiology - April 13, 2020 Category: Cardiology Authors: Islam Y. Elgendy, Ahmed N. Mahmoud, Mohamed Gad, Akram Y. Elgendy, Deepak L. Bhatt Source Type: research

Meta-analysis Comparing Multiple Arterial Grafts versus Single Arterial Graft for Coronary-Artery Bypass Grafting
Observational studies and randomized controlled trials (RCTs) have shown conflicting outcomes for multiple arterial graft (MAG) coronary artery bypass graft surgery (CABG) compared to single arterial grafts (SAGs). The predominant evidence supporting the use of MAGs is observational. The aim of this meta-analysis of RCTs is to compare outcomes following MAG and SAG. We searched multiple databases for RCTs comparing MAG versus SAG. The clinical outcomes studied were all-cause mortality, cardiac mortality, myocardial infarction (MI), revascularization, stroke, sternal wound complications, and major bleeding.
Source: The American Journal of Cardiology - June 14, 2020 Category: Cardiology Authors: Khalid Changal, Saqib Masroor, Ahmed Elzanaty, Mitra Patel, Tanveer Mir, Shayan Khan, Salik Nazir, Ronak Soni, Carson Oostra, Sadik Khuder, Ehab Eltahawy Source Type: research

Drug-eluting Stents Versus Bypass Surgery for Left Main Disease: An updated meta-analysis of randomized controlled trials with long-term follow-up
Debate is ongoing regarding the optimal mode of revascularization for patients with left main coronary artery disease (LMCAD). Longer-term follow-up from randomized trials has recently become available. We recently published a study-level meta-analysis that demonstrated similar mortality after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) when compared with coronary artery bypass grafting (CABG) 1. There were also no differences in cardiac death, stroke or myocardial infarction (MI), although there was a greater risk of unplanned revascularization after PCI.
Source: The American Journal of Cardiology - June 29, 2020 Category: Cardiology Authors: Yousif Ahmad, James P. Howard, Ahran D. Arnold, Ziad A. Ali, Darrel Francis, Jeffrey W. Moses, Martin B. Leon, Ajay J. Kirtane, Dimitri Karmpaliotis, Gregg W. Stone Source Type: research

Outcomes of Transcatheter Aortic Valve Replacement with Percutaneous Coronary Intervention versus Surgical Aortic Valve Replacement with Coronary Artery Bypass Grafting
We aimed to compare the outcomes of combined surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG) to concurrent transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) in a large U.S. population sample. The National Inpatient Sample (NIS) was queried for all patients diagnosed with aortic valve stenosis who underwent SAVR with CABG or TAVR with PCI during the years 2016-2017. Study outcomes included all-cause in-hospital mortality, acute stroke, pacemaker insertion, vascular complications, major bleeding, acute kidney injury, sepsis, non-home discharge, le...
Source: The American Journal of Cardiology - September 25, 2020 Category: Cardiology Authors: Ashraf Abugroun, Mohammed Osman, Saria Awadalla, Lloyd Klein Source Type: research

Outpatient Versus Inpatient Percutaneous Coronary Intervention in Patients with Left Main Disease (From the EXCEL Trial)
Prior studies in patients with non-complex coronary artery disease (CAD) have demonstrated the safety of percutaneous coronary intervention (PCI) in the outpatient setting. We sought to examine the outcomes of outpatient PCI in patients with unprotected left main CAD (LMCAD). In the EXCEL trial, 1905 patients with LMCAD and site-assessed low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus coronary artery bypass grafting. The primary endpoint was major adverse cardiovascular events (MACE; the composite of death, stroke, or MI).
Source: The American Journal of Cardiology - December 22, 2020 Category: Cardiology Authors: Prakriti Gaba, Patrick W. Serruys, Dimitri Karmpaliotis, Nicholas J. Lembo, Adrian P. Banning, Zixuan Zhang, Marie-Claude Morice, David E. Kandzari, Anthony H. Gershlick, Ori Ben-Yehuda, Joseph F. Sabik, Arie Pieter Kappetein, Gregg W. Stone Tags: Outpatient Versus Inpatient PCI in EXCEL Source Type: research

Meta-Analysis of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Left Main Narrowing
Randomized controlled trials (RCTs) comparing percutaneous coronary intervention (PCI) with drug-eluting stents and coronary artery bypass grafting (CABG) for patients with left main coronary artery disease (LMCAD) have reported conflicting results. We performed a systematic review up to May 23, 2021, and 1-stage reconstructed individual patient data meta-analysis (IPDMA) to compare outcomes between both groups. The primary outcome was 10-year all-cause mortality. Secondary outcomes included myocardial infarction (MI), stroke, and unplanned revascularization at 5  years.
Source: The American Journal of Cardiology - April 4, 2022 Category: Cardiology Authors: Nicholas W.S. Chew, Chen-Han Ng, Gwyneth Kong, Keng-Siang Lee, Darren J.H. Tan, Oliver Zi-Hern Lim, Yip Han Chin, Bee Choo Tai, Tianyuan Gu, Seung-Jung Park, Duk-Woo Park, Marie-Claude Morice, Theodoros Kofidis, James W.L. Yip, Poay-Huan Loh, Koo-Hui Chan Source Type: research

Outcomes of Concomitant Coronary Artery Bypass Grafting in Patients With Infective Endocarditis: A Systematic Review and Meta-Analysis
It is current practice to perform concomitant coronary artery bypass grafting (CABG) in patients with infective endocarditis who have relevant coronary artery disease. However, CABG may add complexity to the operation. We performed a systematic review and a meta-analysis of studies that presented outcomes from patients who underwent valve surgery because of infective endocarditis with or without concomitant CABG. Three databases were assessed. Perioperative mortality was the primary outcome. Long-term mortality and postoperative stroke were the secondary outcomes.
Source: The American Journal of Cardiology - August 26, 2023 Category: Cardiology Authors: Tulio Caldonazo, Hristo Kirov, Torsten Doenst, Panagiotis Tasoudis, Alexandros Moschovas, Gloria Faerber, Ricardo E. Treml, Michel Pompeu S á, Murat Mukharyamov, Mahmoud Diab Source Type: research

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