Preferred Revascularization Strategies in Patients with Ischemic Heart Failure: A Meta-Analysis
Preferred Revascularization Strategies in Patients with Ischemic Heart Failure: A Meta-Analysis
复制标题
缺血性心力衰竭患者的首选血运重建策略：荟萃分析
DOI：
10.1007/s11596-018-1944-8
复制
发表时间：
2018-10
影响因子：
2.4
通讯作者：
Jin ping Liu
中科院分区：
文献类型：
--
作者：
Jie Xiao;Fen Xu;Chuan lei Yang;Wei qiang Chen;Xing Chen;Hua Zhang;Zhan jie Wei;Jin ping Liu
临床上一般采用冠状动脉旁路移植术（CABG）或经皮冠状动脉介入治疗（PCI）治疗缺血性心力衰竭。然而，最佳的治疗策略仍然未知。本研究通过荟萃分析检验了两种冠状动脉血运重建术治疗严重缺血性心力衰竭的疗效。比较CABG和PCI疗效的研究来自PubMed、EMBASE、谷歌Scholar和Cochrane Central Register of Controlled Trials （Central）。采用纽卡斯尔-渥太华质量评定量表（Newcastle-Ottawa quality Assessment Scale， NOS）评价入选文献的质量，采用Stata version 12.0软件进行meta分析。最终，纳入12项研究9248例患者（CABG组n=4872例，PCI组n=4376例）进行meta分析，并进行后续池化计算。合并风险比（HR） [HR=0.83, 95% CI (0.76, 0.90)，P<0.001；异质性（P=0.218,I2=22.9%）表明CABG与PCI在长期死亡率方面具有统计学优势。此外，CABG在心肌梗死发生率方面比PCI更具优势[HR=0.51, 95% CI (0.39, 0.67)，P<0.001；异质性，P=0.707,I2=0%]和重复血运重建术[HR=0.40, 95% CI (0.27, 0.59)，P<0.001；异质性,P < 0.001, I2 = 80.1%)。结论是，在给定的临床环境中，CABG似乎比PCI更有利于治疗缺血性心力衰竭。
Clinically, coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is generally used to treat patients with ischemic heart failure. However, the optimal treatment strategy remains unknown. This study examined the efficacy of the two coronary revascularization strategies for severe ischemic heart failure by using a meta-analysis. Studies comparing the efficacy of CABG and PCI were obtained from PubMed, EMBASE, Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL). The quality of each eligible article was evaluated by Newcastle-Ottawa Quality Assessment Scale (NOS), and the meta-analysis was performed using Stata version 12.0 software. Eventually, 12 studies involving 9248 patients (n=4872 in CABG group;n=4376 in PCI group) were subject to the meta-analysis for subsequent pooling calculation. The pooled hazard ratio (HR) [HR=0.83, 95% CI (0.76, 0.90),P<0.001; heterogeneity,P=0.218,I2=22.9%] of CABG compared with that of PCI revealed a statistical superiority of CABG to PCI in terms of the long-term mortality. Furthermore, CABG showed more advantages over PCI with respect to the incidence of myocardial infarction [HR=0.51, 95% CI (0.39, 0.67),P<0.001; heterogeneity,P=0.707,I2=0%] and repeat revascularization [HR=0.40, 95% CI (0.27, 0.59),P<0.001; heterogeneity,P<0.001,I2=80.1%]. It was concluded that CABG appears to be more advantageous than PCI for the treatment of ischemic heart failure in the given clinical setting.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
DOI：
--
发表时间：
1995-05
期刊：
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
影响因子：
--
作者：
J. Ghali
通讯作者：
J. Ghali
影响因子：
4.6
作者：
Nagendran, Jeevan;Norris, Colleen M.;Meyer, Steven R.
通讯作者：
Meyer, Steven R.
影响因子：
0.4
作者：
Moher, David;Liberati, Alessandro;Altman, Douglas G.
通讯作者：
Altman, Douglas G.