Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review
Background: Invasive management of stable coronary artery disease is still a controversial topic. The purpose of this umbrella review was to synthesize systematic reviews (SRs) that evaluate the benefits and harms of percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in pa...
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2024
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| author | Soriano‐Moreno, David R. Fernandez‐Guzman, Daniel Tuco, Kimberly G. Soriano Moreno, Anderson Nelver Elías Ccami‐Bernal, Fabricio Coico-Lama, Abdiel H. Gonzáles Uribe, Antony Gonzalo Taype-Rondan, Alvaro |
| author_browse | Ccami‐Bernal, Fabricio Coico-Lama, Abdiel H. Fernandez‐Guzman, Daniel Gonzáles Uribe, Antony Gonzalo Soriano Moreno, Anderson Nelver Elías Soriano‐Moreno, David R. Taype-Rondan, Alvaro Tuco, Kimberly G. |
| author_facet | Soriano‐Moreno, David R. Fernandez‐Guzman, Daniel Tuco, Kimberly G. Soriano Moreno, Anderson Nelver Elías Ccami‐Bernal, Fabricio Coico-Lama, Abdiel H. Gonzáles Uribe, Antony Gonzalo Taype-Rondan, Alvaro |
| author_sort | Soriano‐Moreno, David R. |
| collection | Producción científica |
| description | Background: Invasive management of stable coronary artery disease is still a controversial topic. The purpose of this umbrella review was to synthesize systematic reviews (SRs) that evaluate the benefits and harms of percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in patients with stable coronary artery disease. Methods: We systematically searched PubMed/MEDLINE, Embase, and CENTRAL from 2018 to August 7, 2022. We included SRs with meta-analyses of randomized controlled trials (RCTs) that evaluated the question of interest. We assessed the methodological quality of the SRs with the AMSTAR-2 tool. We summarized the results of the outcomes for each SR. We calculated the degree of overlap of the RCTs included in the SRs using the corrected covered area (CCA). Results: We found 10 SRs with meta-analyses. The SRs included 3 to 15 RCTs. The degree of overlap among the SRs was very high (CCA > 15%). No SR evaluated the certainty of the evidence using the GRADE system and 9 out of 10 had critically low methodological quality. The SRs reported heterogeneous results for the outcomes of all-cause mortality, myocardial infarction, revascularization, and angina. On the other hand, for the outcomes of cardiovascular mortality and stroke, all SRs agreed that there were no differences between PCI and OMT alone. Conclusions: We found 10 SRs on the use of PCI compared to OMT alone for patients with stable coronary artery disease. However, none had high methodological quality, none evaluated the certainty of the evidence using the GRADE approach, and the results were inconsistent for several outcomes. This variability in evidence may result in divergent clinical decisions for the management of stable coronary artery disease among healthcare professionals. It is necessary to perform a high-quality SR using the GRADE approach to clarify the balance of benefits and harms of PCI. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/575 |
| institution | UPeU |
| language | English |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/5752026-10-30T16:47:49ZPercutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella reviewSoriano‐Moreno, David R.Fernandez‐Guzman, DanielTuco, Kimberly G.Soriano Moreno, Anderson Nelver ElíasCcami‐Bernal, FabricioCoico-Lama, Abdiel H.Gonzáles Uribe, Antony GonzaloTaype-Rondan, AlvaroPercutaneous coronary interventionStable AnginaOptimal Medical TreatmentBackground: Invasive management of stable coronary artery disease is still a controversial topic. The purpose of this umbrella review was to synthesize systematic reviews (SRs) that evaluate the benefits and harms of percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in patients with stable coronary artery disease. Methods: We systematically searched PubMed/MEDLINE, Embase, and CENTRAL from 2018 to August 7, 2022. We included SRs with meta-analyses of randomized controlled trials (RCTs) that evaluated the question of interest. We assessed the methodological quality of the SRs with the AMSTAR-2 tool. We summarized the results of the outcomes for each SR. We calculated the degree of overlap of the RCTs included in the SRs using the corrected covered area (CCA). Results: We found 10 SRs with meta-analyses. The SRs included 3 to 15 RCTs. The degree of overlap among the SRs was very high (CCA > 15%). No SR evaluated the certainty of the evidence using the GRADE system and 9 out of 10 had critically low methodological quality. The SRs reported heterogeneous results for the outcomes of all-cause mortality, myocardial infarction, revascularization, and angina. On the other hand, for the outcomes of cardiovascular mortality and stroke, all SRs agreed that there were no differences between PCI and OMT alone. Conclusions: We found 10 SRs on the use of PCI compared to OMT alone for patients with stable coronary artery disease. However, none had high methodological quality, none evaluated the certainty of the evidence using the GRADE approach, and the results were inconsistent for several outcomes. This variability in evidence may result in divergent clinical decisions for the management of stable coronary artery disease among healthcare professionals. It is necessary to perform a high-quality SR using the GRADE approach to clarify the balance of benefits and harms of PCI.Articlehttps://pubmed.ncbi.nlm.nih.gov/38486733https://doi.org/10.1016/j.heliyon.2024.e27210PMC1093767310.1016/j.heliyon.2024.e27210https://hdl.handle.net/20.500.15037/57538486733W4392345274enHeliyon2405-84402024-03-012026-06-13T08:17:47Z2026-06-13T08:17:47Z |
| spellingShingle | Percutaneous coronary intervention Stable Angina Optimal Medical Treatment Soriano‐Moreno, David R. Fernandez‐Guzman, Daniel Tuco, Kimberly G. Soriano Moreno, Anderson Nelver Elías Ccami‐Bernal, Fabricio Coico-Lama, Abdiel H. Gonzáles Uribe, Antony Gonzalo Taype-Rondan, Alvaro Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review |
| title | Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review |
| title_full | Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review |
| title_fullStr | Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review |
| title_full_unstemmed | Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review |
| title_short | Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review |
| title_sort | percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease an umbrella review |
| topic | Percutaneous coronary intervention Stable Angina Optimal Medical Treatment |
| topic_facet | Percutaneous coronary intervention Stable Angina Optimal Medical Treatment |
| url | https://pubmed.ncbi.nlm.nih.gov/38486733 https://doi.org/10.1016/j.heliyon.2024.e27210 https://hdl.handle.net/20.500.15037/575 |
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