Coronary artery bypass graft surgery versus percutaneous transluminal coronary angioplasty in the treatment of coronary vessel deseases
Perleth M
Record ID 32000001747
German
Authors' objectives:
This report aims to address the question of which patients benefit most from either coronary artery bypass surgery (CABG) or percutaneous transluminal coronary angioplasty (PTCA).
Authors' results and conclusions:
Two meta-analyses, 4 HTA reports, 1 systematic review and 1 guideline based on 9 RCTs were included. In addition, follow-up studies for 6 of the 9 RCTs were identified. Altogether, 5,272 patients have been randomized into the 9 trials, follow-up data ranging from 1 to 8 years. Only 3.6 and 9% of patients screened for inclusion into the trials were actually included. Patients were predominantly men (73-85%) and between 56 and 67 years old. Included patients were suitable for both interventions, had proven symptomatic coronary artery disease and one or more coronary arteries were involved. Patients with stenosis of the left main artery were excluded.
Both interventions are associated with a substantial improvment of angina symptoms. There were no differences in total and cardiac mortality, myocardial infarction, functional status, quality of life, and costs after 3 to 5 years of follow-up. However, patients having PTCA are 4- to 10-fold more likely to undergo a reintervention as compared to CABG, especially in the first year after the intervention. PTCA is also associated with a need for more anti-anginal medication to achieve freedom from angina. One subgroup, patients with treated diabetes, benefit more from CABG in terms of mortality after 5 years.
Authors' recommendations:
For most of the patients satisfying the inclusion criteria, both interventions are similar with respect to most of the outcomes. PTCA patients need more reinterventions and anti-anginal medication, CABG is more invasive. Diabetics benefit significantly more from CABG.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.dimdi.de/
Year Published:
2000
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Germany
MeSH Terms
- Coronary Artery Bypass
Contact
Organisation Name:
German Agency for HTA at the German Institute for Medical Documentation and Information
Contact Address:
German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information, Waisenhausgasse 36-38a, D-50676 Cologne Germany
Contact Name:
dahta@dimdi.de
Contact Email:
dahta@dimdi.de
Copyright:
German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.