PDF(Pubmed)
Abstract：
UNASSIGNED: Repeat coronary artery bypass grafting (RCABG) and percutaneous coronary intervention (PCI) are both used for the treatment of symptomatic patients with coronary artery disease and prior CABG, but the optimal treatment strategy remains unknown. We sought to perform a systematic review and meta-analysis to compare operative and follow-up outcomes following RCABG versus PCI in patients with prior CABG.
UNASSIGNED: Medline and Embase were searched for studies comparing RCABG versus PCI. The primary outcome was follow-up mortality, and secondary outcomes were follow-up repeat revascularization, operative mortality, periprocedural stroke, and myocardial infarction. Time-to-event outcomes were summarized as incidence rate ratios, whereas operative outcomes were summarized as odds ratios. A random effect meta-analysis was performed. Individual patient survival data was extracted from available survival curves and reconstructed using restricted mean survival time.
UNASSIGNED: Among 2982 articles, 7 studies (9945 patients) were included. In the aggregated data meta-analysis, there was no difference in follow-up survival between RCABG and PCI (incidence rate ratio, 1.02; 95% CI, 0.83-1.25); however, restricted mean survival time analysis of individual data showed a survival benefit for RCABG over PCI (0.7 years; 95% CI, 0.23-1.19 years; P = .004). PCI was found to have a higher incidence rate of follow-up need for repeat revascularization (incidence rate ratio, 1.61; 95% CI, 1.16-2.23), but lower odds for operative mortality and stroke. No difference in the odds for myocardial infarction was found.
UNASSIGNED: In patients with prior CABG, PCI is associated with better operative outcomes, but RCABG is associated with better survival and freedom from repeat revascularization at follow-up.
UNASSIGNED: Medline and Embase were searched for studies comparing RCABG versus PCI. The primary outcome was follow-up mortality, and secondary outcomes were follow-up repeat revascularization, operative mortality, periprocedural stroke, and myocardial infarction. Time-to-event outcomes were summarized as incidence rate ratios, whereas operative outcomes were summarized as odds ratios. A random effect meta-analysis was performed. Individual patient survival data was extracted from available survival curves and reconstructed using restricted mean survival time.
UNASSIGNED: Among 2982 articles, 7 studies (9945 patients) were included. In the aggregated data meta-analysis, there was no difference in follow-up survival between RCABG and PCI (incidence rate ratio, 1.02; 95% CI, 0.83-1.25); however, restricted mean survival time analysis of individual data showed a survival benefit for RCABG over PCI (0.7 years; 95% CI, 0.23-1.19 years; P = .004). PCI was found to have a higher incidence rate of follow-up need for repeat revascularization (incidence rate ratio, 1.61; 95% CI, 1.16-2.23), but lower odds for operative mortality and stroke. No difference in the odds for myocardial infarction was found.
UNASSIGNED: In patients with prior CABG, PCI is associated with better operative outcomes, but RCABG is associated with better survival and freedom from repeat revascularization at follow-up.
摘要：
未经证实：重复冠状动脉旁路移植术（RCABG）和经皮冠状动脉介入治疗（PCI）均用于治疗有症状的冠心病患者和既往CABG患者，但最佳治疗策略仍然未知。我们试图进行系统评价和荟萃分析，以比较既往CABG患者在RCABG与PCI术后的手术和随访结果。
UNASSIGNED：在Medline和Embase中搜索比较RCABG与PCI的研究。主要结果是随访死亡率，次要结局是随访重复血运重建，手术死亡率,围手术期中风,和心肌梗塞。事件发生时间结局总结为发生率比率，而手术结局总结为比值比.进行随机效应荟萃分析。从可用的生存曲线中提取个体患者生存数据，并使用有限的平均生存时间进行重建。
未经批准：在2982篇文章中，包括7项研究（9945名患者）。在聚合数据元分析中，RCABG和PCI之间的随访生存率没有差异（发生率比，1.02；95%CI，0.83-1.25)；然而，个体数据的限制性平均生存时间分析显示,RCABG比PCI有生存获益(0.7年;95%CI,0.23-1.19年;P=.004).发现PCI具有较高的重复血运重建需要随访的发生率（发生率比，1.61；95%CI，1.16-2.23），但手术死亡率和中风的几率较低。心肌梗塞的几率没有差异。
未经批准：在先前有CABG的患者中，PCI与更好的手术结果相关，但RCABG在随访时与更好的生存率和避免重复血运重建相关.
UNASSIGNED：在Medline和Embase中搜索比较RCABG与PCI的研究。主要结果是随访死亡率，次要结局是随访重复血运重建，手术死亡率,围手术期中风,和心肌梗塞。事件发生时间结局总结为发生率比率，而手术结局总结为比值比.进行随机效应荟萃分析。从可用的生存曲线中提取个体患者生存数据，并使用有限的平均生存时间进行重建。
未经批准：在2982篇文章中，包括7项研究（9945名患者）。在聚合数据元分析中，RCABG和PCI之间的随访生存率没有差异（发生率比，1.02；95%CI，0.83-1.25)；然而，个体数据的限制性平均生存时间分析显示,RCABG比PCI有生存获益(0.7年;95%CI,0.23-1.19年;P=.004).发现PCI具有较高的重复血运重建需要随访的发生率（发生率比，1.61；95%CI，1.16-2.23），但手术死亡率和中风的几率较低。心肌梗塞的几率没有差异。
未经批准：在先前有CABG的患者中，PCI与更好的手术结果相关，但RCABG在随访时与更好的生存率和避免重复血运重建相关.
