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Table 12.8PCI vs. CABG – Single vessel disease – medium term follow-up (2 to 4 years) for stable angina

Quality assessmentSummary of findings
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsPCICABGRelative (95% CI)Absolute
Death (all causes) (follow-up 2. years)
Drenth 2004155; Goy 2000156 (SIMA); Hueb 199585 (MASS-1)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none2/185 (1.1%)6/180 (3.3%)RR 0.37 (0.09 to 1.60)21 fewer per 1000 (from 30 fewer to 20 more)[plus sign in circle][plus sign in circle]○○

LOW
Cardiac death (follow-up 2–2.5 years)
Drenth 2004155; Goy 1994157; Goy 2000156 (SIMA)randomised trialsserious (e)no serious inconsistencyno serious indirectnessserious (b)none1/181 (0.6%)4/176 (2.3%)RR 0.39 (0.08 to 2)14 fewer per 1000 (from 21 fewer to 23 more)[plus sign in circle][plus sign in circle]○○

LOW
MI (follow-up 2–2.5 years)
Drenth 2004155; Goy 1994157; Goy 2000156 (SIMA); Hueb 199585 (MASS-1)randomised trialsserious (c)no serious inconsistencyno serious indirectnessserious (d)none18/253 (7.1%)6/246 (2.4%)RR 2.92 (1.18 to 7.21)47 more per 1000 (from 4 more to 151 more)[plus sign in circle][plus sign in circle]○○

LOW
Repeat revascularisation (follow-up 2–2.5 years)
Drenth 2004155; Goy 1994157; Goy 2000156 (SIMA); Hueb 199585 (MASS-1)randomised trialsserious (c)no serious inconsistencyno serious indirectnessno serious imprecisionnone67/253 (26.5%)4/246 (1.6%)RR 13.27 (5.41 to 32.51)200 more per 1000 (from 72 more to 512 more)[plus sign in circle][plus sign in circle][plus sign in circle]

MODERATE
Free of angina
Drenth 2004155; Goy 1994157; Hueb 199585 (MASS-1)randomised trialsserious (e)no serious inconsistencyno serious indirectnessserious (d)none144/191 (75.4%)168/184 (91.3%)RR 0.83 (0.75 to 0.91)155 fewer per 1000 (from 82 fewer to 228 fewer)[plus sign in circle][plus sign in circle]○○

LOW
Stroke (follow-up 2 years)
Drenth 2004155; Goy 2000156 (SIMA)randomised trialsserious (f)no serious inconsistencyno serious indirectnessserious (b)none2/113 (1.8%)0/110 (0%)RR 5 (0.25 to 101.63)20 more per 1000 (from 20 fewer to 50 more)[plus sign in circle][plus sign in circle]○○

LOW
a

Drenth 2004[147]; Goy 2000[148] (SIMA); Hueb 1995[83] (MASS-1): Randomisation, ITT reported in both studies. Allocation concealment not reported in 2 out of 3 studies.

b

95% CI around the pooled estimate of effect includes both: 1) no effect and 2) appreciable benefit or appreciable harm.

c

Drenth 2004[147]; Goy 1994[149]; Goy 2000[148] (SIMA); Hueb 1995[83] (MASS-1): Randomisation, ITT reported in all 4studies. Allocation concealment not reported in all 4 studies.

d

95% CI around the pooled estimate of effect includes appreciable benefit or appreciable harm.

e

Drenth 2004[147]; Goy 1994[149]; Hueb 1995[83] (MASS-1): Randomisation, ITT reported all 3 studies. Allocation concealment not reported in all 3 studies.

f

Drenth 2004[147]; Goy 2000[148] (SIMA): Randomisation, ITT reported both studies. Allocation concealment not reported in all both studies.

Drenth 2004[147]; Goy 2000[148] (SIMA); Hueb 1995[83] (MASS-1): Randomisation, ITT reported in both studies. Allocation concealment not reported in 2 out of 3 studies.

95% CI around the pooled estimate of effect includes both: 1) no effect and 2) appreciable benefit or appreciable harm.

Drenth 2004[147]; Goy 1994[149]; Goy 2000[148] (SIMA); Hueb 1995[83] (MASS-1): Randomisation, ITT reported in all 4studies. Allocation concealment not reported in all 4 studies.

95% CI around the pooled estimate of effect includes appreciable benefit or appreciable harm.

Drenth 2004[147]; Goy 1994[149]; Hueb 1995[83] (MASS-1): Randomisation, ITT reported all 3 studies. Allocation concealment not reported in all 3 studies.

Drenth 2004[147]; Goy 2000[148] (SIMA): Randomisation, ITT reported both studies. Allocation concealment not reported in all both studies.

From: 12, Revascularisation

Cover of Stable Angina
Stable Angina: Methods, Evidence & Guidance [Internet].
NICE Clinical Guidelines, No. 126.
National Clinical Guidelines Centre (UK).
Copyright © 2011, National Clinical Guidelines Centre.

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