Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study

Abstract To estimate death probabilities after coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), and medical therapy (MT) in patients under 60 years old. We conducted a search systematic on PubMed, Embase, Cochrane Library, and Web of Science up to January 2021. The stud...

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Autores principales:	Mohammad Afrouzi, Farbod Ebadi Fard Azar, Ali Aboutorabi, Marjan Hajahmadi, Seyed Javad Ebadi
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Coronary artery disease Death probabilities Revascularization Medical therapy Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/cc1e0d5f20714e67b07b5d7fa19108a1
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spelling	oai:doaj.org-article:cc1e0d5f20714e67b07b5d7fa19108a12021-11-08T10:57:51ZMortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study10.1186/s43044-021-00225-x2090-911Xhttps://doaj.org/article/cc1e0d5f20714e67b07b5d7fa19108a12021-11-01T00:00:00Zhttps://doi.org/10.1186/s43044-021-00225-xhttps://doaj.org/toc/2090-911XAbstract To estimate death probabilities after coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), and medical therapy (MT) in patients under 60 years old. We conducted a search systematic on PubMed, Embase, Cochrane Library, and Web of Science up to January 2021. The study included three parts. In the probabilities part (A), Comprehensive Meta-Analysis, and in the comparison parts (B and C), Review Manager was used in conducting meta-analyses. Nine studies consisting of 16,410 people with a mean age of 51.2 ± 6 years were included in the meta-analysis. Over a mean follow-up of 3.7 ± 2 years, overall mortality after CABG, PCI and MT was 3.6% (95% CI 0.021–0.061), 4.3% (95% CI 0.023–0.080) and 9.7% (95% CI 0.036–0.235), respectively. The length of follow-up periods was almost the same and did not differ much (p = 0.19). In Part B (without adjustment of baseline characteristics), 495 (4.0%) of 12,198 patients assigned to CABG died compared with 748 (4.5%) of 16,458 patients assigned to PCI (risk ratio [RR]: 0.77, 95% CI 0.50–1.20; p = 0.25). Seventy-four (3.5%) of 2120 patients assigned to CABG and 68 (4.2%) of 1621 patients assigned to PCI died compared with 103 (9.5%) of 1093 patients assigned to MT in equal follow-up periods (CABG-MT: RR 0.34; 95% CI 0.23–0.51; p < 0.002) (PCI-MT: RR 0.40; 95% CI 0.30–0.53; p = 0.02). In Part C, overall mortality after PCI in PACD patients with STEMI was higher in elderly versus young (RR 2.64; 95% CI 2.11–3.30) and is lower in men versus women (RR 0.61; 95% CI 0.44–0.83). Mortality probabilities obtained are one of the most important factors of effectiveness in the economic evaluation studies; these rates can be used to determine the cost-effectiveness of procedures in CAD patients aged < 60 years.Mohammad AfrouziFarbod Ebadi Fard AzarAli AboutorabiMarjan HajahmadiSeyed Javad EbadiSpringerOpenarticleCoronary artery diseaseDeath probabilitiesRevascularizationMedical therapyDiseases of the circulatory (Cardiovascular) systemRC666-701ENThe Egyptian Heart Journal, Vol 73, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Coronary artery disease Death probabilities Revascularization Medical therapy Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Coronary artery disease Death probabilities Revascularization Medical therapy Diseases of the circulatory (Cardiovascular) system RC666-701 Mohammad Afrouzi Farbod Ebadi Fard Azar Ali Aboutorabi Marjan Hajahmadi Seyed Javad Ebadi Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study
description	Abstract To estimate death probabilities after coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), and medical therapy (MT) in patients under 60 years old. We conducted a search systematic on PubMed, Embase, Cochrane Library, and Web of Science up to January 2021. The study included three parts. In the probabilities part (A), Comprehensive Meta-Analysis, and in the comparison parts (B and C), Review Manager was used in conducting meta-analyses. Nine studies consisting of 16,410 people with a mean age of 51.2 ± 6 years were included in the meta-analysis. Over a mean follow-up of 3.7 ± 2 years, overall mortality after CABG, PCI and MT was 3.6% (95% CI 0.021–0.061), 4.3% (95% CI 0.023–0.080) and 9.7% (95% CI 0.036–0.235), respectively. The length of follow-up periods was almost the same and did not differ much (p = 0.19). In Part B (without adjustment of baseline characteristics), 495 (4.0%) of 12,198 patients assigned to CABG died compared with 748 (4.5%) of 16,458 patients assigned to PCI (risk ratio [RR]: 0.77, 95% CI 0.50–1.20; p = 0.25). Seventy-four (3.5%) of 2120 patients assigned to CABG and 68 (4.2%) of 1621 patients assigned to PCI died compared with 103 (9.5%) of 1093 patients assigned to MT in equal follow-up periods (CABG-MT: RR 0.34; 95% CI 0.23–0.51; p < 0.002) (PCI-MT: RR 0.40; 95% CI 0.30–0.53; p = 0.02). In Part C, overall mortality after PCI in PACD patients with STEMI was higher in elderly versus young (RR 2.64; 95% CI 2.11–3.30) and is lower in men versus women (RR 0.61; 95% CI 0.44–0.83). Mortality probabilities obtained are one of the most important factors of effectiveness in the economic evaluation studies; these rates can be used to determine the cost-effectiveness of procedures in CAD patients aged < 60 years.
format	article
author	Mohammad Afrouzi Farbod Ebadi Fard Azar Ali Aboutorabi Marjan Hajahmadi Seyed Javad Ebadi
author_facet	Mohammad Afrouzi Farbod Ebadi Fard Azar Ali Aboutorabi Marjan Hajahmadi Seyed Javad Ebadi
author_sort	Mohammad Afrouzi
title	Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study
title_short	Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study
title_full	Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study
title_fullStr	Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study
title_full_unstemmed	Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study
title_sort	mortality probabilities after revascularization and medical therapy in cad patients under 60 years old: a meta-analysis study
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/cc1e0d5f20714e67b07b5d7fa19108a1
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Mortality probabilities after revascularization and medical therapy in CAD patients under 60 years old: a meta-analysis study

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