Table 2. Overview of meta-analyses.
| Author, date | Studies included |
Total number of patients | Years at follow-up | Mortality | Myocardial infarction (MI) | Stroke or cerebrovascular event | Repeat revascularization (RR) | Notes |
|---|---|---|---|---|---|---|---|---|
| Hakeem et al., 2013 (25) | 4 RCTs | 3,052 | 4 years | Favors CABG | Favors CABG | Favors PCI | Favors CABG | CABG in diabetic patients with MVD at low to intermediate surgical risk (EuroSCORE <5) is superior to MVD PCI with DES |
| Garcia et al., 2013 (27) | 35 studies | 89,883 | – | – | – | – | – | Complete revascularization is more commonly achieved with CABG than PCI |
| Incomplete revascularization has increased mortality and RR independently on the mode of treatment | ||||||||
| Al Ali et al., 2014 (20) | 7 RCTs; MVD + LMD | 5,835 | 6 months–5 years | Favors CABG | Favors CABG | Favors PCI | Favors CABG | In MVD patients, CABG reduced the risk of mortality, but increased stroke |
| In patients with LM disease, CABG reduced revascularization risk and increased stroke risk | ||||||||
| Sipahi et al., 2014 (21) | 6 RCT | 6,055 | 4.1 years | Favors CABG | Favors CABG | Non-significant | Favors CABG | CABG is superior to PCI independently on diabetes |
| Lim et al., 2014 (24) | 5 RCT; 9 OBS | 5,000 | 3 to 5 years | Favors CABG | Favors CABG | 30 days: favours PCI; 1–5 years: non-significant | Favors CABG | Cardiovascular/cerebrovascular event were 1.71 times higher in the DES/PCI |
| D’Ascenzo et al., 2014 (26) | 20 RCT; aimed at correlating risk factors | 12,844 | 30 days to 1 year | Favors CABG | Favors CABG | Favors PCI | Favors CABG | PCI reduces the risk of stroke in female patients: PCI has increased risk of RR risk in women and in those with diabetes |
| Fanari et al., 2015 (23) | 6 RCT | 5,123 | 1 and 5 years | 1-year: non-significant; 5-year: favors CABG | 1 year: non-significant; 5 years: favours CABG | Favors PCI | Favors CABG | Increased death in diabetics with PCI |
| Zimarino et al., 2016 (28) | 28 studies | 83,695 | 4.7 ± 4.3 years | – | – | – | – | CR confers benefit on outcomes more evident in diabetics |
| Benedetto et al., 2016 (19) | 5 RCT | 4,563 | 3.4 years | Favors CABG | Favors CABG | Favors PCI | Favors CABG | PCI increase mortality by 51%; PCI increase MI by 102%; CABG increase stroke by 29% |
| Lee et al., 2016 (10) | 3 RCT; MVD + LMD | 3,280 | 5 years | MVD: favors CABG; LMD: non-significant |
MVD: favors CABG; LMD: favors CABG | Non-significant | Favors CABG | Overall CABG educed long-term rates of the composite of all-cause death, myocardial infarction, or stroke in patients with LMD and MVD |
| Benefit of CABG more pronounced in MVD | ||||||||
| Chang et al., 2016 (29) | BEST + SYNTAX in non-diabetics | 1,275 | 62 months | Favors CABG | Favors CABG | No differences | Favors CABG | CABG, as compared with DES-PCI educed the long-term risk of mortality in nondiabetic patients with MVD CAD |
| Cavalcante et al., 2017 (30) | BEST + SYNTAX | 1,166 | 5 years | Favors CABG | Favors CABG | No differences | Favors CABG | In MVD with proximal LAD involvement, CABG has lower rates of the composite endpoint of death, MI or stroke |
| Head et al., 2018 (31) | 11 RCT; MVD + LMD | 11,518 | 5 years | Favors CABG in complex MVD and diabetes; LMD: non-significant | – | – | – | CABG benefit restricted to MVD + diabetes |
| Equivalence for LMD | ||||||||
| Equivalence for MVD in non-diabetic patients |
MVD, multivessel disease; LMD, left main disease; CR, complete revascularization; DES-PCI, Drug-eluting stents percutaneous coronary intervention; OBS, observational; RCT, randomized controlled trial; CABG, coronary artery bypass grafting; CAD, cardiovascular disease.