摘要
Abstract
Objective To systematically review the efficacy and safety of drug-eluting stent(DES) versus coronary artery bypass grafting(CABG) in the treatment of left anterior descending coronary artery(CAD) stenosis.Methods Literature about the efficacy and safety of DES versus CABG for LAD stenosis was retrieved from digital databases of MEDLINE, EMbase, PubMed, and the Cochrane Library by November 2016.Data extraction and quality assessment of included studies were conducted by two independent reviewers.RevMan 5.3 software was used to perform meta-analysis.Results Ten studies involving 9771 patients were finally included.The results of meta-analysis showed that there was no significant difference in mortality [RR=0.88,95%CI(0.70,1.11),P=0.28],major adverse cardiovascular events[MACE,RR=1.04,95%CI(0.88,1.24),P=0.63] or myocardial infarction [MI,RR=0.92,95%CI(0.56,1.53),P=0.75], but PCI-DES significantly increased the risk of TVR [OR=2.43,95%CI(1.61,3.69),P<0.0001].Conclusion For LAD stenosis, PCI-DES strategy causes as high a rate of mortality, MACE and MI as CABG or DES, but PCI-DES can significantly increase the risk of TVR, so we should be cautious clinically.关键词
冠心病/药物洗脱支架/冠状动脉旁路移植术/左前降支病变/荟萃分析/系统评价Key words
coronary heart disease/drug eluting stent/coronary artery bypass grafting/left anterior descending coronary disease/meta-analysis/systematic review分类
医药卫生
