title: Percutaneous coronary invervention versus coronary artery bypass grafting: a meta-analysis.
abstract: OBJECTIVE
  To compare the effectiveness of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with coronary artery disease.
  
  
  METHODS
  MEDLINE, Embase, and Cochrane Central were searched, and randomized controlled trials were included. Outcomes were assessed at maximum available follow-up.
  
  
  RESULTS
  This meta-analysis includes 31 trials with 15,004 patients. As regards death, more patients died after PCI compared with CABG across all types of patients (odds ratio [OR], 1.1; 95% confidence interval [CI], 1.0-1.3; P = .05) as well as in patients with multivessel disease (OR, 1.2; 95% CI, 1.0-1.4; P = .02) or diabetes (OR, 1.6; 95% CI, 1.2-2.1; P < .01). Myocardial infarction occurred as frequently after PCI (OR, 1.2; 95% CI, 0.9-1.5; P = .28). Repeat revascularization was more common after PCI (OR, 4.5; 95% CI, 3.5-5.8; P < .01), with a progressive decline in ORs from the pre-stent era (OR, 7.0; 95% CI, 5.1-9.7; P < .01), to the bare metal stent era (OR, 4.5; 95% CI, 3.6-5.5; P < .01), and to the drug-eluting stent era (OR, 2.5; 95% CI, 1.8-3.4; P < .01). Stroke was more common after CABG (OR, 0.7; 95% CI, 0.5-0.9; P = .01).
  
  
  CONCLUSIONS
  Compared with PCI, CABG had a lower risk of death in multivessel disease or diabetes patients eligible for either intervention, a lower risk of repeat revascularization, but a higher risk of stroke.
authors.affiliation: Independent Researcher, Leuth, The Netherlands.
authors.forename: Yolba
authors.initials: Y
authors.lastname: Smit
authors.affiliation: ME-TA, Rotselaar, Belgium.
authors.forename: Joan
authors.initials: J
authors.lastname: Vlayen
authors.affiliation: Independent Researcher, Vlissingen, The Netherlands.
authors.forename: Hetty
authors.initials: H
authors.lastname: Koppenaal
authors.affiliation: Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Eefting
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medisch Centrum, Rotterdam, The Netherlands.
authors.forename: Arie Pieter
authors.initials: AP
authors.lastname: Kappetein
authors.affiliation: Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: m.mariani@umcg.nl.
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Mariani
mesh_terms: D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome