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IMPACT OF HYPERTENSION ON REVASCULARIZATION OUTCOMES: A PRISMA-BASED SYSTEMATIC REVIEW COMPARING PCI AND CABG IN MULTIVESSEL CORONARY ARTERY DISEASE

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1. Verfasser: Dar, Shehneela
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author Dar, Shehneela
author_facet Dar, Shehneela
contents <p><strong><u><span>IMPACT OF HYPERTENSION ON REVASCULARIZATION OUTCOMES: A PRISMA-BASED SYSTEMATIC REVIEW COMPARING PCI AND CABG IN MULTIVESSEL CORONARY ARTERY DISEASE</span></u></strong></p> <p><span> </span></p> <p><strong><span>Authors and Affiliations</span></strong></p> <ul> <li><span>Dr. Shehneela Dar, MD., USMLE and Dr. Pawel Kostyrko, MD.</span></li> <li><span>Department of Stroke and Neurology, St Michael’s Hospital, University Health Network (UHN), University of Toronto, Canada</span></li> <li><span>Corresponding Author: </span><a href="mailto:Shehneela.dar@unityhealth.to"><span>Shehneela.dar@unityhealth.to</span></a></li> </ul> <p><strong><span> </span></strong></p> <p><span><span>·<span>         </span></span></span><strong><span>DOI: <span>10.5281/zenodo.17970225</span></span></strong></p> <p><span><span>·<span>         </span></span></span><span>ORCID ID: </span><a href="https://orcid.org/0009-0004-8320-649X"><span>https://orcid.org/0009-0004-8320-649X</span></a><span> </span></p> <p><span><span>·<span>         </span></span></span><span>Google Scholar ID:  </span><a href="https://scholar.google.ca/citations?user=8K0XYrgAAAAJ&hl=en"><span>https://scholar.google.ca/citations?user=8K0XYrgAAAAJ&hl=en</span></a></p> <p><strong><span> </span></strong></p> <p><strong><span>Abstract: </span></strong><span>Hypertension (HTN) is a pervasive comorbidity in patients with multivessel coronary artery disease (MVCAD) that complicates revascularization by accelerating atherosclerosis and increasing procedural risks. The optimal revascularization strategy—Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG)—for this specific high-risk subgroup remains a subject of significant clinical debate. To systematically review and compare the long-term clinical outcomes, including Major Adverse Cardiac and Cerebrovascular Events (MACCE), mortality, and repeat revascularization, in hypertensive adults with MVCAD undergoing PCI vs. CABG. Following PRISMA 2020 guidelines, a systematic search of PubMed, Embase, and the Cochrane Library was conducted for studies published between 2010 and 2025. Inclusion criteria focused on randomized controlled trials (RCTs) and high-quality observational data comparing drug-eluting stent (DES)-based PCI with CABG in hypertensive cohorts. Synthesis of data from seven major trials and registries indicates that hypertensive patients with high anatomical complexity (SYNTAX score) experience significantly lower rates of MACCE and repeat revascularization with CABG. While PCI consistently offers a lower 30-day stroke risk, CABG provides superior protection against spontaneous myocardial infarction. Hypertension correlates with higher rates of in-stent restenosis in PCI, whereas arterial grafts in CABG appear more resilient to blood pressure fluctuations. For hypertensive patients with complex MVCAD, CABG remains the preferred strategy to reduce long-term MACCE. PCI is a viable alternative for patients with lower anatomical complexity or those at prohibitive surgical risk.</span></p> <p><strong><span>Keywords:</span></strong><span> Hypertension, MVCAD, PCI, CABG, PRISMA, Systematic Review, Revascularization.</span></p>
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spellingShingle IMPACT OF HYPERTENSION ON REVASCULARIZATION OUTCOMES: A PRISMA-BASED SYSTEMATIC REVIEW COMPARING PCI AND CABG IN MULTIVESSEL CORONARY ARTERY DISEASE
Dar, Shehneela
<p><strong><u><span>IMPACT OF HYPERTENSION ON REVASCULARIZATION OUTCOMES: A PRISMA-BASED SYSTEMATIC REVIEW COMPARING PCI AND CABG IN MULTIVESSEL CORONARY ARTERY DISEASE</span></u></strong></p> <p><span> </span></p> <p><strong><span>Authors and Affiliations</span></strong></p> <ul> <li><span>Dr. Shehneela Dar, MD., USMLE and Dr. Pawel Kostyrko, MD.</span></li> <li><span>Department of Stroke and Neurology, St Michael’s Hospital, University Health Network (UHN), University of Toronto, Canada</span></li> <li><span>Corresponding Author: </span><a href="mailto:Shehneela.dar@unityhealth.to"><span>Shehneela.dar@unityhealth.to</span></a></li> </ul> <p><strong><span> </span></strong></p> <p><span><span>·<span>         </span></span></span><strong><span>DOI: <span>10.5281/zenodo.17970225</span></span></strong></p> <p><span><span>·<span>         </span></span></span><span>ORCID ID: </span><a href="https://orcid.org/0009-0004-8320-649X"><span>https://orcid.org/0009-0004-8320-649X</span></a><span> </span></p> <p><span><span>·<span>         </span></span></span><span>Google Scholar ID:  </span><a href="https://scholar.google.ca/citations?user=8K0XYrgAAAAJ&hl=en"><span>https://scholar.google.ca/citations?user=8K0XYrgAAAAJ&hl=en</span></a></p> <p><strong><span> </span></strong></p> <p><strong><span>Abstract: </span></strong><span>Hypertension (HTN) is a pervasive comorbidity in patients with multivessel coronary artery disease (MVCAD) that complicates revascularization by accelerating atherosclerosis and increasing procedural risks. The optimal revascularization strategy—Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG)—for this specific high-risk subgroup remains a subject of significant clinical debate. To systematically review and compare the long-term clinical outcomes, including Major Adverse Cardiac and Cerebrovascular Events (MACCE), mortality, and repeat revascularization, in hypertensive adults with MVCAD undergoing PCI vs. CABG. Following PRISMA 2020 guidelines, a systematic search of PubMed, Embase, and the Cochrane Library was conducted for studies published between 2010 and 2025. Inclusion criteria focused on randomized controlled trials (RCTs) and high-quality observational data comparing drug-eluting stent (DES)-based PCI with CABG in hypertensive cohorts. Synthesis of data from seven major trials and registries indicates that hypertensive patients with high anatomical complexity (SYNTAX score) experience significantly lower rates of MACCE and repeat revascularization with CABG. While PCI consistently offers a lower 30-day stroke risk, CABG provides superior protection against spontaneous myocardial infarction. Hypertension correlates with higher rates of in-stent restenosis in PCI, whereas arterial grafts in CABG appear more resilient to blood pressure fluctuations. For hypertensive patients with complex MVCAD, CABG remains the preferred strategy to reduce long-term MACCE. PCI is a viable alternative for patients with lower anatomical complexity or those at prohibitive surgical risk.</span></p> <p><strong><span>Keywords:</span></strong><span> Hypertension, MVCAD, PCI, CABG, PRISMA, Systematic Review, Revascularization.</span></p>
title IMPACT OF HYPERTENSION ON REVASCULARIZATION OUTCOMES: A PRISMA-BASED SYSTEMATIC REVIEW COMPARING PCI AND CABG IN MULTIVESSEL CORONARY ARTERY DISEASE
url https://doi.org/10.5281/zenodo.17970225

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