HYBRID CORONARY REVASCULARIZATION VERSUS CORONARY ARTERY BYPASS GRAFT IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE A META-ANALYSIS

Zghouzi, Mohamed; Ullah, Waqas; Sandhyavenu, Hariogopal; Pacha, Homam Moussa; Al-Khadra, Yasser; Ahmad, Bachar; Sattar, Yasar; Suleiman, Abdul-Rahman; Garcia, Santiago; Bagur, Rodrigo; Ali, Omar; Gardi, Delair; Hakim, Zaher; Mohamed, Mohamed; Rashid, Muhammad; Mamas, Mamas; Alraies, M. Chadi

Abstract

Background
Hybrid coronary artery revascularization (HCR) refers to complete or near complete revascularization using the combination of single vessel CABG and PCI of other significant coronary lesions. The short-term outcomes of HCR compared to CABG alone is unknown.

Methods
Online databases were queried with various combinations of keywords to identify relevant articles. Major adverse cardiovascular events (MACE) and its components were compared using a random effect model to calculate unadjusted odds ratios (OR).

Results
A total of 36 studies comprising 213,053 patients (HCR 4,276, CABG 208,777) were included. The odds of MACE (OR 1.22; 95% CI 0.86-1.74; P=0.27), repeat MI (OR 1.02; 95% CI 0.66-1.60; P=0.91), cerebrovascular events (OR 0.82; 95% CI 0.55-1.24; P=0.35), all cause mortality (OR 1.13; 95% CI 0.72-1.79; P=0.59), AKI (OR 1.09; 95% CI 0.55-2.19; P=0.8), hemodialysis (OR 0.49; 95% CI 0.14-1.66; P=0.25), postoperative Afib (OR 0.76; 95% CI 0.53-1.09; P=0.13), complete revascularization (OR 0.97; 95% CI 0.62-1.52; P=0.9), and TVR (OR 2.68; 95% CI 0.47-15.25; P=0.27) were not different between the two groups. Although the odds of blood transfusion requirement was significantly lower in the HCR group (OR 0.37; 95% CI 0.31-0.44; P<0.001), the need for repeat operation due to bleeding was similar between the two groups (OR 1.03; 95% CI 0.75-1.42; P=0.84).

Conclusion
Clinical outcomes of HCR and CABG were comparable for patients with MCAD, with no difference in mortality or major adverse events.

Citation

Zghouzi, M., Ullah, W., Sandhyavenu, H., Pacha, H. M., Al-Khadra, Y., Ahmad, B., Sattar, Y., Suleiman, A.-R., Garcia, S., Bagur, R., Ali, O., Gardi, D., Hakim, Z., Mohamed, M., Rashid, M., Mamas, M., & Alraies, M. C. (2021). HYBRID CORONARY REVASCULARIZATION VERSUS CORONARY ARTERY BYPASS GRAFT IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE A META-ANALYSIS. Journal of the American College of Cardiology, 77(18), 1042. https://doi.org/10.1016/s0735-1097%2821%2902401-3

• Journal Article Type: Article
• Acceptance Date: May 3, 2021
• Online Publication Date: May 3, 2021
• Publication Date: 2021-05
• Deposit Date: Jun 23, 2023
• Journal: Journal of the American College of Cardiology
• Print ISSN: 0735-1097
• Electronic ISSN: 1558-3597
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 77
• Issue: 18
• Pages: 1042
• DOI: https://doi.org/10.1016/s0735-1097%2821%2902401-3
• Keywords: Cardiology and Cardiovascular Medicine
• Public URL: https://keele-repository.worktribe.com/output/503542