IJCS | Volume 31, Nº2, March / April 2018

155 –0.2 –0.1 0.2 0 0.1 Favours stent Favours CABG Heterogeneity: Chi 2 = 7.31, df = 8 (p = 0.50); I 2 = 0% Test for overall effect: Z = 0.25 (p = 0.080) Total events 143 145 Subtotal (95% CI) 4191 70.3% 4138 –0.00 [–0.01, 0.01] Boudriot et al. 2011 2 100 5 101 1.7% –0.03 [–0.08, 0.02] CARDIa 2010 8 254 8 246 4.2% –0.00 [–0.03, 0.03] EXCEL 2010 38 948 38 948 16.0% –0.00 [–0.02, 0.02] FREEDOM 2012 32 953 30 953 16.1% –0.00 [–0.01, 0.02] NOBLE 2016 9 592 17 592 10.0% –0.01 [–0.03, 0.00] PRECOMBAT 2011 6 300 8 300 5.1% –0.01 [–0.03, 0.02] SYNTAX LM 2009 39 891 30 849 14.7% 0.01 [–0.01, 0.03] VA-CARDIS 2013 8 101 5 97 1.7% 0.03 [–0.04, 0.10] LE MANS 2008 1 52 4 52 0.9% –0.06 [–0.14, 0.02] Study or Subgroup Stent Events Total Weight Risk Difference Risk Difference M-H, Fixed, 95% CI CABG Events Total M-H, Fixed, 95% CI Figure 2 – Mortality at 1 year: stent versus coronary artery bypass grafting. The size of the squares is proportional to the number of patients. The bars represent 95% confidence intervals. The diamond represents the synthesis of the results. Abbreviations: CABG: coronary artery bypass grafting; SYNTAX: Synergy between PCI with Taxus and Cardiac Surgery; CARDia: Coronary Artery Revascularization in Diabetes; LE MANS: Left Main Coronary Artery Stenting; FREEDOM: Future Revascularization Evaluation in Patients with Diabetes Mellitus; VA CARDS: Coronary Artery Revascularization in Diabetes; BEST: Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease; NOBLE: Nordic-Baltic-British Left Main Revascularization; Boudriot: study by Boudriot et al.: J Am Coll Cardiol. 2011; 57: 538-545 . Graph obtained using the software Review Manager (RevMan), version 5.3. –0.2 –0.1 0.2 0 0.1 Favours stent Favours CABG Heterogeneity: Chi 2 = 6.85, df = 7 (p = 0.44); I 2 = 0% Test for overall effect: Z = 2.58 (p = 0.010) Total events 435 353 Subtotal (95% CI) 4292 70.9% 4175 0.02 [0.00, 0.03] BEST 2015 28 437 22 440 7.3% 0.01 [–0.02, 0.04] CARDIa 2010 35 254 31 248 4.2% 0.01 [–0.05, 0.07] EXCEL 2010 71 913 53 903 15.2% 0.02 [–0.00, 0.04] FREEDOM 2012 114 894 83 859 14.7% 0.03 [0.00, 0.06] NOBLE 2016 36 592 33 592 9.9% 0.01 [–0.02, 0.03] PRECOMBAT 2011 17 279 23 275 4.6% –0.02 [–0.07, 0.02] SYNTAX LM 2009 123 871 92 805 14.0% 0.03 [–0.00, 0.06] LE MANS 2008 11 52 16 53 0.9% –0.09 [–0.26, 0.08] Study or Subgroup Stent Events Total Weight Risk Difference Risk Difference M-H, Fixed, 95% CI CABG Events Total M-H, Fixed, 95% CI Figure 3 – Late mortality: stent versus coronary artery bypass grafting. The size of the boxes is proportional to the number of patients. The bars represent 95% confidence intervals. The diamond represents the synthesis of the results. Abbreviations: CABG: coronary artery bypass grafting; SYNTAX: Synergy between PCI with Taxus and Cardiac Surgery; CARDia: Coronary Artery Revascularization in Diabetes; LE MANS: Left Main Coronary Artery Stenting; FREEDOM: Future Revascularization Evaluation in Patients with Diabetes Mellitus; VA CARDS: Coronary Artery Revascularization in Diabetes; BEST: Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease; PRECOMBAT: Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease; EXCEL: Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization; NOBLE: Nordic-Baltic-British Left Main Revascularization Study; Boudriot: study by Boudriot et al.: J Am Coll Cardiol. 2011; 57: 538-545 . Graph obtained using the software Review Manager (RevMan), version 5.3. Andrade et al. Stent versus surgery: randomized trials Int J Cardiovasc Sci. 2018;31(2)152-162 Original Article score in the upper tertile and the occurrence of diabetes had a strong negative influence on the PCI outcome. In patients in the lower SYNTAX tertile and in those without diabetes, there was no significant difference in terms of MACCE between the CABG and PCI groups. The elderly condition and the female gender contributed to the difference in results but to a lesser degree. An ejection fraction < 50% did not contribute significantly to the difference in results.