Coronary disease & ACSMeta-analysis
Non-ST-elevation acute coronary syndromes with previous coronary artery bypass grafting: a meta-analysis of invasive vs. conservative management
- Systematic review and meta-analysis of randomised trials
- random-effects model
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
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