Elective revascularization with PCI or CABG provides long-term cardiovascular benefits, new meta-analysis confirms
Elective coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting surgery (CABG) leads to a significant reduction in the risk of cardiac death among patients with stable ischemic heart disease, according to a new meta-analysis of nearly 20,000 patients.
The findings, presented virtually at EuroPCR 2021, included data from 25 different randomized clinical trials conducted from 1979 to 2020.
Previously, the team behind the ISCHEMIA trial reported finding no significant difference between taking an invasive or a more conservative approach to treating patients with chronic coronary syndromes. However, researchers hoped that a meta-analysis could paint a more complete picture and help address certain limitations of the ISCHEMIA trial.
Overall, the authors found that treating patients with PCI or CABG plus medical therapy instead of just medical therapy alone was associated with a 21% reduction in late cardiovascular death. Also, this benefit appeared to increase as time went on for patients who underwent PCI or CABG—as the time after treatment increase, their risk of death continued to decrease.
Also, the researchers identified a 24% reduction in spontaneous myocardial infarction when clinicians choose a more invasive initial approach.
“This comprehensive analysis clearly defines a risk-reduction in cardiovascular mortality following coronary revascularization in patients with stable coronary artery disease that is directly related to both duration of follow-up and magnitude of risk reduction in spontaneous myocardial infarction,” Dean Kereiakes, MD, medical director of the Christ Hospital Research Institute in Cincinnati, Ohio, and co-author of the meta-analysis, said in a statement from the Society for Cardiovascular Angiography and Interventions. “This mechanistically plausible benefit of revascularization is evident through multiple sensitivity analyses.”
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.