Influence of previous percutaneous coronary intervention on clinical outcome of coronary artery bypass grafting: a meta-analysis of comparative studies
The prognostic significance of previous percutaneous coronary intervention (PCI) in patients undergoing coronary artery bypass grafting (CABG) is still unclear. Although many studies have reported adverse effects of previous PCI on postoperative mortality in CABG, as yet no meta-analysis has been ca...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2015-04, Vol.20 (4), p.531-537 |
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| creator | Ueki, Chikara Sakaguchi, Genichi Akimoto, Takehide Shintani, Tsunehiro Ohashi, Yuko Sato, Hirofumi |
| description | The prognostic significance of previous percutaneous coronary intervention (PCI) in patients undergoing coronary artery bypass grafting (CABG) is still unclear. Although many studies have reported adverse effects of previous PCI on postoperative mortality in CABG, as yet no meta-analysis has been carried out. We conducted this first meta-analysis to assess whether previous PCI increases postoperative mortality in CABG. MEDLINE and EMBASE were searched for relevant articles up to and including April 2014. Studies published in English satisfying the following criteria were included in the meta-analysis: (i) comparing CABG patients with previous PCI versus without previous PCI; and (ii) reporting hospital mortality. Our search identified 23 comparative studies, including 174 777 patients: 19 179 with previous PCI and 155 598 without previous PCI. Pooled analysis demonstrated that previous PCI had an adverse effect on hospital mortality: odds ratio (OR) 1.187, 95% confidence interval (CI) 1.075–1.312. Furthermore, subgroup analysis stratified by the proportion of multiple previous PCI (i.e. number of patients with multiple previous PCI/number of patients with single or multiple previous PCI) was performed. In the subgroup of studies with the proportion |
| doi_str_mv | 10.1093/icvts/ivu449 |
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Although many studies have reported adverse effects of previous PCI on postoperative mortality in CABG, as yet no meta-analysis has been carried out. We conducted this first meta-analysis to assess whether previous PCI increases postoperative mortality in CABG. MEDLINE and EMBASE were searched for relevant articles up to and including April 2014. Studies published in English satisfying the following criteria were included in the meta-analysis: (i) comparing CABG patients with previous PCI versus without previous PCI; and (ii) reporting hospital mortality. Our search identified 23 comparative studies, including 174 777 patients: 19 179 with previous PCI and 155 598 without previous PCI. Pooled analysis demonstrated that previous PCI had an adverse effect on hospital mortality: odds ratio (OR) 1.187, 95% confidence interval (CI) 1.075–1.312. Furthermore, subgroup analysis stratified by the proportion of multiple previous PCI (i.e. number of patients with multiple previous PCI/number of patients with single or multiple previous PCI) was performed. In the subgroup of studies with the proportion <40%, the adverse effect was not significant: OR 0.897 (95% CI 0.723–1.113); however, in the subgroup of studies with the proportion ≥40%, the adverse effect of previous PCI was significant: OR 1.987 (95% CI 1.563–2.526). A meta-regression coefficient was significantly positive for the proportion of patients with a history of multiple PCI (coefficient 0.841; 95% CI 0.457–1.226; P < 0.001). This meta-analysis would argue that as the proportion of patients with multiple previous PCI in the CABG cohort increases, postoperative mortality also increases. This result re-emphasizes the importance of the heart team approach to coronary revascularization.</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1093/icvts/ivu449</identifier><identifier>PMID: 25583647</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Coronary Artery Bypass - adverse effects ; Coronary Artery Bypass - mortality ; Coronary Artery Disease - mortality ; Coronary Artery Disease - surgery ; Coronary Artery Disease - therapy ; Hospital Mortality ; Humans ; Odds Ratio ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - mortality ; Postoperative Complications - mortality ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2015-04, Vol.20 (4), p.531-537</ispartof><rights>The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2015</rights><rights>The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. 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Although many studies have reported adverse effects of previous PCI on postoperative mortality in CABG, as yet no meta-analysis has been carried out. We conducted this first meta-analysis to assess whether previous PCI increases postoperative mortality in CABG. MEDLINE and EMBASE were searched for relevant articles up to and including April 2014. Studies published in English satisfying the following criteria were included in the meta-analysis: (i) comparing CABG patients with previous PCI versus without previous PCI; and (ii) reporting hospital mortality. Our search identified 23 comparative studies, including 174 777 patients: 19 179 with previous PCI and 155 598 without previous PCI. Pooled analysis demonstrated that previous PCI had an adverse effect on hospital mortality: odds ratio (OR) 1.187, 95% confidence interval (CI) 1.075–1.312. Furthermore, subgroup analysis stratified by the proportion of multiple previous PCI (i.e. number of patients with multiple previous PCI/number of patients with single or multiple previous PCI) was performed. In the subgroup of studies with the proportion <40%, the adverse effect was not significant: OR 0.897 (95% CI 0.723–1.113); however, in the subgroup of studies with the proportion ≥40%, the adverse effect of previous PCI was significant: OR 1.987 (95% CI 1.563–2.526). A meta-regression coefficient was significantly positive for the proportion of patients with a history of multiple PCI (coefficient 0.841; 95% CI 0.457–1.226; P < 0.001). This meta-analysis would argue that as the proportion of patients with multiple previous PCI in the CABG cohort increases, postoperative mortality also increases. This result re-emphasizes the importance of the heart team approach to coronary revascularization.</description><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary Artery Disease - therapy</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Odds Ratio</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - mortality</subject><subject>Postoperative Complications - mortality</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1LJDEQhoO4-H3zLLm5B3tNOp3uiTeR1R0Q9rJ7bmoyFYl0J20-GuaX-HftmdY5CoFKUU8eqLyEXHL2izMlbq0eU7y1Y64qdUBOuKxVocqFPNzflTgmpzG-MsYVE-yIHJdSLkRdNSfkfelMl9FppN7QIeBofY50wKBzAofbRvvgHYQNtS5hGNEl6x2dju6ssxo66nPSvt8p9jCECd7Q1WaAGOlLAJOse7mjQHtMUICDbhNtnN_0AwRIdkQaU15bjOfkh4Eu4sVnPSP_H3__e_hTPP99Wj7cPxda1DwVoGq2ahpjpBJalmKNjJULU5bSMIFc8mneaM2Rw1o3jVohNFpVdWMqpsCAOCM_Z-8Q_FvGmNreRo1dN-_e8rqWvGSTaEJvZlQHH2NA0w7B9tOqLWftNop2F0U7RzHhV5_mvOpxvYe__n4CrmfA5-F71QcpjJkT</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Ueki, Chikara</creator><creator>Sakaguchi, Genichi</creator><creator>Akimoto, Takehide</creator><creator>Shintani, Tsunehiro</creator><creator>Ohashi, Yuko</creator><creator>Sato, Hirofumi</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201504</creationdate><title>Influence of previous percutaneous coronary intervention on clinical outcome of coronary artery bypass grafting: a meta-analysis of comparative studies</title><author>Ueki, Chikara ; Sakaguchi, Genichi ; Akimoto, Takehide ; Shintani, Tsunehiro ; Ohashi, Yuko ; Sato, Hirofumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-a960b77ff593c523de0028f225f03e1519607cc1e1adc779bea7c9467f409afa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary Artery Disease - therapy</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Odds Ratio</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - mortality</topic><topic>Postoperative Complications - mortality</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ueki, Chikara</creatorcontrib><creatorcontrib>Sakaguchi, Genichi</creatorcontrib><creatorcontrib>Akimoto, Takehide</creatorcontrib><creatorcontrib>Shintani, Tsunehiro</creatorcontrib><creatorcontrib>Ohashi, Yuko</creatorcontrib><creatorcontrib>Sato, Hirofumi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Ueki, Chikara</au><au>Sakaguchi, Genichi</au><au>Akimoto, Takehide</au><au>Shintani, Tsunehiro</au><au>Ohashi, Yuko</au><au>Sato, Hirofumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of previous percutaneous coronary intervention on clinical outcome of coronary artery bypass grafting: a meta-analysis of comparative studies</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2015-04</date><risdate>2015</risdate><volume>20</volume><issue>4</issue><spage>531</spage><epage>537</epage><pages>531-537</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>The prognostic significance of previous percutaneous coronary intervention (PCI) in patients undergoing coronary artery bypass grafting (CABG) is still unclear. Although many studies have reported adverse effects of previous PCI on postoperative mortality in CABG, as yet no meta-analysis has been carried out. We conducted this first meta-analysis to assess whether previous PCI increases postoperative mortality in CABG. MEDLINE and EMBASE were searched for relevant articles up to and including April 2014. Studies published in English satisfying the following criteria were included in the meta-analysis: (i) comparing CABG patients with previous PCI versus without previous PCI; and (ii) reporting hospital mortality. Our search identified 23 comparative studies, including 174 777 patients: 19 179 with previous PCI and 155 598 without previous PCI. Pooled analysis demonstrated that previous PCI had an adverse effect on hospital mortality: odds ratio (OR) 1.187, 95% confidence interval (CI) 1.075–1.312. Furthermore, subgroup analysis stratified by the proportion of multiple previous PCI (i.e. number of patients with multiple previous PCI/number of patients with single or multiple previous PCI) was performed. In the subgroup of studies with the proportion <40%, the adverse effect was not significant: OR 0.897 (95% CI 0.723–1.113); however, in the subgroup of studies with the proportion ≥40%, the adverse effect of previous PCI was significant: OR 1.987 (95% CI 1.563–2.526). A meta-regression coefficient was significantly positive for the proportion of patients with a history of multiple PCI (coefficient 0.841; 95% CI 0.457–1.226; P < 0.001). This meta-analysis would argue that as the proportion of patients with multiple previous PCI in the CABG cohort increases, postoperative mortality also increases. This result re-emphasizes the importance of the heart team approach to coronary revascularization.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>25583647</pmid><doi>10.1093/icvts/ivu449</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford Journals Open Access Collection |
| subjects | Coronary Artery Bypass - adverse effects Coronary Artery Bypass - mortality Coronary Artery Disease - mortality Coronary Artery Disease - surgery Coronary Artery Disease - therapy Hospital Mortality Humans Odds Ratio Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - mortality Postoperative Complications - mortality Risk Assessment Risk Factors Time Factors Treatment Outcome |
| title | Influence of previous percutaneous coronary intervention on clinical outcome of coronary artery bypass grafting: a meta-analysis of comparative studies |
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