Table 11.12Medical vs. PCI – Multi-vessel disease – Short term follow-up (1 year) for stable angina

Quality assessmentSummary of findings
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsMedicalPCIRelative (95% CI)Absolute
Death (follow-up 1 years)
Hueb 200468 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none3/203 (1.5%)9/205 (4.4%)RR 0.34 (0.09 to 1.23)29 fewer per 1000 (from 40 fewer to 10 more)⊕⊕○○

LOW
Q wave MI (follow-up 1 years)
Hueb 200468 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none10/203 (4.9%)16/205 (7.8%)RR 0.63 (0.29 to 1.36)29 fewer per 1000 (from 55 fewer to 28 more)⊕⊕○○

LOW
Stroke (follow-up 1 years)
Hueb 200468 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none3/203 (1.5%)2/205 (1%)RR 1.51 (0.26 to 8.97)5 more per 1000 (from 7 fewer to 78 more)⊕⊕○○

LOW
Non protocol revascularisation (follow-up 1 years) (d)
Hueb 200468 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none16/203 (7.9%)25/205 (12.2%)RR 0.65 (0.36 to 1.17)43 fewer per 1000 (from 78 fewer to 21 more)⊕⊕○○

LOW
Free of angina (follow-up 1 years)
Hueb 200468 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (c)none74/203 (36.5%)107/205 (52.2%)RR 0.7 (0.56 to 0.87)157 fewer per 1000 (from 68 fewer to 230 fewer)⊕⊕○○

LOW
Death- Sub group diabetes (follow-up 1 years)
Soares 200669 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none2/75 (2.7%)3/56 (5.4%)RR 0.5 (0.09 to 2.88)27 fewer per 1000 (from 49 fewer to 101 more)⊕⊕○○

LOW
Death- Subgroup no diabetes (follow-up 1 years)
Soares 200669 (MASS-II)randomised trialsserious (a)no serious inconsistencyno serious indirectnessserious (b)none2/128 (1.6%)8/149 (5.4%)RR 0.29 (0.06 to 1.35)38 fewer per 1000 (from 50 fewer to 19 more)⊕⊕○○

LOW
a

MASS-II: Randomised. Allocation concealment unclear. More patients in PCI group had MI and fewer were current or past smokers; other characteristics similar at baseline; could indicate these patients had worse disease. In CABG group, 4/203 declined surgery and received medical therapy. In PCI group, 6/205 had CABG instead, 3 declined PCI and received medical therapy and 2 died before treatment.

b

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

c

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

d

Medical treatment group – 12 non protocol CABG and 4 non protocol PCI; PCI group- 7 non protocol CABG and 18 non protocol PCI; CABG group-1 non protocol PCI.

From: 11, Medical versus revascularisation interventions

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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