Mortality and myocardial infarction following surgical versus percutaneous revascularization of isolated left anterior descending artery disease: a meta-analysis☆
Bibliographic record
Abstract
OBJECTIVE: Despite numerous studies comparing surgical versus percutaneous revascularization, the optimal treatment of patients with isolated left anterior descending (LAD) artery disease remains debated. We conducted a meta-analysis to study the early and mid-term outcomes following percutaneous and surgical treatment of isolated LAD disease. METHODS: Medline, EMBASE, and the Cochrane databases were searched and a hand search of bibliographies was conducted. Clinical data was extracted independently by two individuals. Random effects models were used to calculate pooled risk ratios (RR) and meta-regression was employed to explain study heterogeneity. Stratified analyses were conducted and a Funnel plot was used to assess publication bias. RESULTS: Eight randomized trials (1110 patients; median follow-up: 2.1 years, range: 0.5-5 years) and nine observational studies (12,209 patients; median follow-up: 3 years, range: 0.5-5.5 years) were identified and analyzed separately. Both randomized and observational studies demonstrated a beneficial effect of surgery compared to percutaneous therapy on mid-term major adverse cardiac events (MACE) (RR [95% CI]: 0.33 [0.24-0.46] for randomized and 0.32 [0.24-0.41] for observational studies). Studies with >1 year of follow-up demonstrated a beneficial effect of surgery compared to percutaneous therapy on combined mortality and MI rates for randomized (RR [95% CI]: 0.59 [0.35-0.98]) and observational studies (RR [95% CI]: 0.81 [0.65-0.99]). The start year was identified as a source of study heterogeneity. CONCLUSIONS: Surgical treatment of isolated LAD disease is associated with reduced MACE, reduced mortality, and MI rates at mid-term follow-up, as well as lower recurrence of angina. Evolution of treatment strategies may explain some of the variability between studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.053 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".