title: Short, Intermediate and long term outcomes of CABG vs. PCI with DES in Patients With Multivessel Coronary Artery Disease. Meta-Analysis of Six Randomized Controlled Trials.
abstract: OBJECTIVE
  Comparing outcomes of percutaneous coronary intervention (PCI) with drug eluting stent (DES) and Coronary Artery Bypass Grafting (CABG) in patients with multivessel Coronary Artery Disease (CAD) using data from randomized controlled trials (RCT).
  
  
  BACKGROUND
  PCI and CABG are established strategies for coronary revascularization in the setting of ischemic heart disease. Multiple RCT have compared outcomes of the two modalities in patients with multivessel CAD.
  
  
  METHODS
  We did a meta-analysis from six RCT in the contemporary era comparing the effectiveness of PCI with DES to at 1 year, 2 years and 5 years respectively.
  
  
  RESULTS
  Compared to CABG, at one year PCI was associated with a significantly higher incidence of TVR (RR= 2.31; 95% CI: [1.80 - 2.96]; P=<0.0001), lower incidence of stroke (RR= 0.35; 95% CI: [0.19 - 0.62]; P=0.0003), and no difference in death (RR= 1.02; 95% CI: [0.77 - 1.36]; P= 0.88) or MI (RR= 1.16; 95% CI: [0.72 - 1.88]; P= 0.53). At 5 years, PCI was associated with a higher incidence of death (RR= 1.3; 95% CI: [1.10 - 1.54]; P= 0.0026) and MI (RR= 2.21; 95% CI: [1.75 - 2.79]; P=<0.0001). While the higher incidence of MI with PCI was noticed in both diabetic and non-diabetics, death was increased mainly in diabetic patients.
  
  
  CONCLUSIONS
  In patients with multi-vessel CAD, PCI with DES is associated with no significant difference in death or MI at 1 or 2 years. However at 5 years, PCI is associated with higher incidence of death and MI.
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Zaher
authors.initials: Z
authors.lastname: Fanari
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Weiss
authors.affiliation: Value Institute, Christiana Care Health System, Newark, DE.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Value Institute, Christiana Care Health System, Newark, DE.
authors.forename: Seema S
authors.initials: SS
authors.lastname: Sonnad
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE ; Value Institute, Christiana Care Health System, Newark, DE.
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
keywords: Coronary Artery Bypass Grafting; Drug Eluting Stents; Meta-Analysis; Percutaneous coronary intervention; Randomized Control Trials