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Open Access 01-12-2019 | CABG | Protocol

Coronary artery bypass surgery plus medical therapy versus medical therapy alone for ischaemic heart disease: a protocol for a systematic review with meta-analysis and trial sequential analysis

Authors: Ulver Spangsberg Lorenzen, Katrine Bredahl Buggeskov, Emil Eik Nielsen, Naqash Javaid Sethi, Christian Lildal Carranza, Christian Gluud, Janus Christian Jakobsen

Published in: Systematic Reviews | Issue 1/2019

Abstract

Background

Despite increasing survival, cardiovascular disease remains the primary cause of death worldwide with an estimated 7.4 million annual deaths. The main symptom of ischaemic heart disease is chest pain (angina pectoris) most often caused by blockage of a coronary artery. The aim of coronary artery bypass surgery is revascularisation achieved by surgically grafting harvested arteries or veins distal to the coronary lesion restoring blood flow to the heart muscle. Older evidence suggested a clear survival benefit of coronary artery bypass graft surgery, but more recent trials yield less clear evidence. We want to assess the benefits and harms of coronary artery bypass surgery combined with different medical therapies versus medical therapy alone in patients with ischaemic heart disease.

Methods

This protocol for a systematic review follows the recommendations of Cochrane and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all randomised clinical trials assessing coronary artery bypass surgery combined with different medical therapies versus medical therapy alone in patients with ischaemic heart disease. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed as high risk or low risk of bias, and our conclusions will primarily be based on trials at low risk of bias. The analyses of the extracted data will be performed using Review Manager 5, STATA 16 and trial sequential analysis. For both our primary and secondary outcomes, we will create a ‘Summary of Findings’ table and use GRADE to assess the certainty of the evidence.

Discussion

Coronary artery bypass surgery is invasive and can cause death, which is why its use must be thoroughly studied to determine if it yields a large enough long-term benefit for the thousands of patients receiving it every year.

Systematic review registration

PROSPERO ID 131924

Available only for authorised users

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Title: Coronary artery bypass surgery plus medical therapy versus medical therapy alone for ischaemic heart disease: a protocol for a systematic review with meta-analysis and trial sequential analysis
Authors: Ulver Spangsberg Lorenzen
Katrine Bredahl Buggeskov
Emil Eik Nielsen
Naqash Javaid Sethi
Christian Lildal Carranza
Christian Gluud
Janus Christian Jakobsen
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: CABG
CABG
Published in: Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-019-1155-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Coronary artery bypass surgery plus medical therapy versus medical therapy alone for ischaemic heart disease: a protocol for a systematic review with meta-analysis and trial sequential analysis

Abstract

Background

Methods

Discussion

Systematic review registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Discussion

Systematic review registration

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