Coronary disease & ACS

Non-ST-elevation acute coronary syndromes with previous coronary artery bypass grafting: a meta-analysis of invasive vs. conservative management

Eur Heart JPublished Systematic review and meta-analysis of randomised trials

Authors' conclusion

The results confirm the under-representation of this patient group in RCTs of invasive management in NSTE-ACS and suggest that there is no benefit to a routine invasive strategy compared to a conservative approach with regard to major adverse cardiac events.

Study context

Population
Patients with previous coronary artery bypass graft (CABG) presenting with NSTE-ACS
Participants
897 patients · 11 randomized controlled trials (RCTs)
Comparison
Routine invasive vs conservative/selective invasive strategy
  • Routine invasiven = 477
  • Conservative/selective invasiven = 420reference
Methodological detailsrandom-effects model
  • Random-effects model

Pooled result

As reported in the abstract

All-cause mortality, cardiac mortality, MI, cardiac-related hospitalization · weighted mean 2.0 (range 0.5-10) years
Routine invasive vs Conservative/selective invasiveRelative risk (95% CI)
All-cause mortality
1.12(0.97–1.29)
Cardiac mortality
1.05(0.70–1.58)
MI
0.90(0.65–1.23)
Cardiac-related hospitalization
1.05(0.78–1.40)

Original publication

Non-ST-elevation acute coronary syndromes with previous coronary artery bypass grafting: a meta-analysis of invasive vs. conservative management. Eur Heart J. Published 28 May 2024. doi:10.1093/eurheartj/ehae245

Summarised from the published abstract; every number is checked against it

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