Medical therapy versus percutaneous coronary intervention or coronary artery bypass graft in stable coronary artery disease; a systematic review and meta-analysis of randomized clinical trials

  • سال انتشار: 1401
  • محل انتشار: مجله آریا آترواسکلروز، دوره: 18، شماره: 5
  • کد COI اختصاصی: JR_RYA-18-5_004
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 232
دانلود فایل این مقاله

نویسندگان

Majid Davari

Associate Professor, Department of Pharmacoeconomics and Pharma Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Mende Sorato

PhD Candidate, Department of Pharmacoeconomics and Pharma Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Behzad Fatemi

PhD Candidate, Department of Pharmacoeconomics and Pharma Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Soheila Rezaei

PhD Candidate, Department of Pharmacoeconomics and Pharma Administration, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Hamid Sanei

Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

چکیده

BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of this disease. The main aim of this study was the comparison of MT with PCI or CABG in terms of cardiovascular (CV) mortality, myocardial infarction (MI), unplanned revascularization (UR), stroke, and freedom from angina in managing stable CAD. METHODS: The Cochrane Central Register of Controlled Trials, Embase, PubMed, and Scopus were searched. Two reviewers independently appraised the titles and abstracted data of the identified studies. After the Full-text reviewing phase, eligible studies were analyzed through the random-effect meta-analysis method. Finally, a sensitivity analysis was conducted for the robustness of findings. RESULTS: Nine randomized controlled trials (RCTs) were included. The pooled RR of CV mortality associated with MT compared with PCI and CABG was ۱.۲۲ and ۱.۳۸۵, respectively. Overall, The RR of MT associated with MI, UR, stroke, and freedom from angina compared with PCI was ۱.۰۰۱, ۱.۱۵۱, ۰.۷۹۹, and ۰.۸۰۱, respectively. CONCLUSION: Our results revealed no statistically significant difference between MT and PCI in terms of studied primary outcomes. The findings also highlighted that there is no statistically significant difference between MT and CABG in terms of CV mortality.

کلیدواژه ها

Coronary Artery Disease, Myocardial Infarction, Medication Therapy Management, Percutaneous Coronary Intervention, Coronary Artery Bypass Grafting, Meta-Analysis

اطلاعات بیشتر در مورد COI

COI مخفف عبارت CIVILICA Object Identifier به معنی شناسه سیویلیکا برای اسناد است. COI کدی است که مطابق محل انتشار، به مقالات کنفرانسها و ژورنالهای داخل کشور به هنگام نمایه سازی بر روی پایگاه استنادی سیویلیکا اختصاص می یابد.

کد COI به مفهوم کد ملی اسناد نمایه شده در سیویلیکا است و کدی یکتا و ثابت است و به همین دلیل همواره قابلیت استناد و پیگیری دارد.