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Author Spotlight: Enhancing Coronary Artery Revascularization
05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

899

Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis

Jef Van den Eynde1,2, Michel Pompeu Sá3,4, Senne De Groote1

  • 1Department of Cardiovascular Diseases, University Hospitals Leuven & Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.

International Journal of Cardiology. Heart & Vasculature
|December 17, 2021
PubMed

Insights

Hybrid coronary revascularization (HCR) may be a viable alternative to percutaneous coronary intervention (PCI) for multivessel coronary artery disease. HCR showed lower rates of myocardial infarction and target vessel revascularization in a recent meta-analysis.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Hybrid coronary revascularization (HCR) combines surgical and percutaneous coronary intervention (PCI) benefits for multivessel coronary artery disease (MVD).
  • HCR aims to improve long-term outcomes while reducing short-term complications and recovery time.

Purpose of the Study:

  • To evaluate the effectiveness of HCR compared to PCI in patients with MVD.
  • To compare major adverse cardiac and cerebrovascular events (MACCE) between HCR and PCI at 30 days and latest follow-up.

Main Methods:

  • Systematic database search of PubMed/MEDLINE, Embase, Scopus, and CENTRAL/CCTR up to June 2021.
  • Random-effects meta-analysis comparing HCR versus PCI outcomes.
  • Inclusion of seven studies with 27,041 patients (939 HCR, 26,102 PCI) published between 2013 and 2021.

Main Results:

  • At latest follow-up, HCR was associated with significantly lower rates of myocardial infarction (MI) (OR 0.40) and target vessel revascularization (TVR) (OR 0.49).
  • The difference in MACCE between HCR and PCI did not reach statistical significance (OR 0.46).
  • No significant differences were observed in 30-day outcomes, mortality, or stroke rates at latest follow-up.

Conclusions:

  • HCR presents a potentially valid alternative to multivessel PCI for MVD.
  • Lower MI and TVR incidence with HCR suggests potential benefits.
  • Optimal patient selection, heart team coordination, and center experience are crucial for successful HCR outcomes.
Abstract

Keywords:
CABG, coronary artery bypass graftingCI, confidence intervalClinical outcomesHCR, hybrid coronary revascularizationHybrid coronary revascularizationLAD, left anterior descending coronary arteryLITA, left internal thoracic arteryMACCE, major adverse cardiac and cerebrovascular eventsMD, mean differenceMI, myocardial infarctionMVD, multivessel coronary artery diseaseMeta-analysisOR, odds ratioPCI, percutaneous coronary interventionPRISMA, Preferred Reporting Items for Systematic reviews Meta-AnalysesPercutaneous coronary InterventionTVR, target vessel revascularization

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