Meta-analysis
Effects of Elective Coronary Revascularization vs Medical Therapy Alone on Noncardiac Mortality
- Systematic review and meta-analysis of randomised trials
- random-effects models
- trial sequential analysis
- Bayesian meta-analysis
- meta-regression
Authors' conclusion
In patients with CCS, noncardiac mortality in late follow-up was similar for revascularization plus MT compared with MT alone.
Study context
- Population
- Patients with chronic coronary syndrome (CCS)
- Participants
- 16,908 patients · 18 RCTs
- Comparison
- Revascularization plus medical therapy (MT) vs MT alone
- Revascularization plus MTn = 8,665
- MT alonen = 8,243reference
- Outcome
- Noncardiac mortality
- Follow-up
- Longest
Pooled result
As reported in the abstract
No significant difference in noncardiac mortality between the assigned treatment groups (RR, 95% CI)
RR: 1.09; 95% CI: 0.94-1.26; P = 0.26
Further pooled results
| Outcome | P value |
|---|---|
| Effect of follow-up duration on noncardiac death rates (meta-regression) · follow-up duration did not affect noncardiac death rates | P = 0.52 |
Noncardiac mortality, excluding the ISCHEMIA trial
- Results consistent without the ISCHEMIA trial (RR, 95% CI)
- RR: 1.00; 95% CI: 0.84-1.18; P = 0.97
Trial sequential analysis
- Cumulative Z-curve within the nonsignificance area, reaching futility boundaries
Noncardiac mortality, Bayesian meta-analysis
- Consistent with the standard approach (RR, 95% CrI)
- RR: 1.08; 95% credible interval: 0.90-1.31
Original publication
Effects of Elective Coronary Revascularization vs Medical Therapy Alone on Noncardiac Mortality. JACC Cardiovasc Interv. Published 22 May 2023. doi:10.1016/j.jcin.2023.02.030
Summarised from the published abstract; every number is checked against it