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Meta-Analysis
. 2017 Mar 2:7:43801.
doi: 10.1038/srep43801.

Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery and the SYNTAX score: A systematic review and meta-analysis

Pravesh Kumar Bundhun  1 , Chandra Mouli Yanamala  2 , Feng Huang  1
Affiliations
Meta-Analysis

Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery and the SYNTAX score: A systematic review and meta-analysis

Pravesh Kumar Bundhun et al. Sci Rep. .

Abstract

The SYNTAX [Synergy Between percutaneous coronary intervention (PCI) With Taxus and coronary artery bypass surgery (CABG)] score is a decision-making tool in interventional cardiology. However, several facts still remain to be addressed: What about PCI or CABG with a low versus a high score respectively? And what about PCI with a low score versus CABG with a high score? Electronic databases were carefully searched for relevant publications. Odds ratios (OR) with 95% confidence intervals (CIs) were calculated and the analysis was carried out by RevMan 5.3. Eleven studies with a total number of 11,037 patients were included. In terms of clinical outcomes, this analysis showed PCI to have significantly favored patients with a low versus a high SYNTAX score. In patients who were re-vascularized by CABG, mortality and major adverse cardiac events were significantly lower with a low SYNTAX score. However, when PCI with a low SYNTAX score was compared with CABG with a high SYNTAX score, no significant difference in mortality and combined death/stroke/myocardial infarction were observed. In conclusion, the SYNTAX score might be considered useful in interventional cardiology. Nevertheless, the fact that it has limitations when compared to newer tools should also not be ignored.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Flow diagram representing the study selection.
Figure 2
Figure 2. Outcomes associated with percutaneous coronary intervention following a low versus a high SYNTAX score.
Figure 3
Figure 3. Myocardial infarction associated with percutaneous coronary intervention following a low versus a high SYNTAX score.
Figure 4
Figure 4. Mortality associated with percutaneous coronary intervention following a low versus a high SYNTAX score.
Figure 5
Figure 5. Outcomes associated with coronary artery bypass surgery following a low versus a high SYNTAX score.
Figure 6
Figure 6. Myocardial infarction associated with coronary artery bypass surgery following a low versus a high SYNTAX score.
Figure 7
Figure 7. Mortality associated with coronary artery bypass surgery following a low versus a high SYNTAX score.
Figure 8
Figure 8. Outcomes associated with percutaneous coronary intervention in patients with a low SYNTAX score versus coronary artery bypass surgery in patients with a high SYNTAX score.
Figure 9
Figure 9. Mortality associated with percutaneous coronary intervention in patients with a low SYNTAX score versus coronary artery bypass surgery in patients with a high SYNTAX score.
Figure 10
Figure 10. Funnel plot showing publication bias.
Figure 11
Figure 11. Funnel plot showing publication bias.
See this image and copyright information in PMC

References

    1. Heidenreich P. A. et al.. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 123(8), 933–44 (2011). - PubMed
    1. Bundhun P. K. et al.. Adverse Cardiovascular Outcomes associated with Coronary Artery Bypass Surgery and PercutaneousCoronary Intervention with Everolimus Eluting Stents: A Meta-Analysis. Sci Rep. 6, 35869 (2016). - PMC - PubMed
    1. Pandey A. et al.. Revascularization Trends in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease Presenting With Non-ST Elevation Myocardial Infarction: Insights From the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines (NCDR ACTION Registry-GWTG). Circ Cardiovasc Qual Outcomes. 9(3), 197–205 (2016). - PubMed
    1. Franzone A. et al.. Angiographic complexity of coronary artery disease according to SYNTAX score and clinical outcomes after revascularisation with newer-generation drug-eluting stents: a substudy of the BIOSCIENCE trial. EuroIntervention. 12(5), e595–604 (2016). - PubMed
    1. Amsterdam E. A. et al.. American College of Cardiology; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons; American Association for Clinical Chemistry. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute CoronarySyndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 64(24), e139–228 (2014). - PubMed

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