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Updated: Jan 8, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Hybrid coronary revascularization vs. PCI in high-risk multivessel coronary artery disease: a two-center, two-year
Ting Luo1, Dong Yi1, Lingzhi Qiu1
1Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.
Insights
Hybrid coronary revascularization (HCR) offers better symptom relief and fewer major adverse cardiac and cerebrovascular events (MACCE) than percutaneous coronary intervention (PCI) for high-risk multivessel coronary artery disease (MV-CAD). This supports HCR as a viable treatment option.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Surgical Innovation
Background:
- Multivessel coronary artery disease (MV-CAD) treatment options include PCI, CABG, and HCR.
- HCR combines LIMA-to-LAD grafting with PCI for non-LAD lesions.
- Limited comparative data exists for HCR versus PCI in high-risk MV-CAD patients.
Purpose of the Study:
- To compare the efficacy and safety of HCR versus PCI in high-risk MV-CAD patients.
- To evaluate long-term outcomes including MACCE and symptom relief.
Main Methods:
- Retrospective analysis of 330 high-risk MV-CAD patients (109 HCR, 221 PCI) over 2 years.
- Primary endpoint: MACCE (all-cause death, stroke, MI, repeat revascularization, angina).
- Kaplan-Meier survival analysis and statistical tests were employed.
Main Results:
- HCR used fewer and shorter stents than PCI.
- Despite longer hospital stay and higher costs, HCR showed significantly lower rates of angina (5.5% vs. 17.2%) and MACCE (12.8% vs. 23.5%) at 2 years.
- Kaplan-Meier analysis favored HCR for overall survival (log-rank P=0.0006).
Conclusions:
- HCR demonstrates superior long-term symptom relief and reduced MACCE compared to PCI in high-risk MV-CAD.
- HCR is a viable strategy for carefully selected patients.
- Prospective multicenter studies are warranted to validate these findings.
Background:
Treatment strategies for multivessel coronary artery disease (MV-CAD) include percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and the increasingly adopted hybrid coronary revascularization (HCR). HCR combines minimally invasive left internal mammary artery (LIMA)-to-left anterior descending (LAD) grafting with PCI of non-LAD lesions. However, comparative evidence in high-risk MV-CAD remains limited.
Methods:
We retrospectively analyzed 330 high-risk MV-CAD patients from two centers (HCR n = 109; PCI n = 221) over 2 years. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE: all-cause death, stroke, myocardial infarction, repeat revascularization, and angina). Kaplan-Meier survival analysis and conventional statistical tests were applied.
Results:
Baseline demographics and SYNTAX scores were similar between groups. HCR involved fewer and shorter stents than PCI. Hospital stay, ICU duration, and total costs were higher with HCR. At 2 years, angina (5.5% vs. 17.2%; P = 0.003) and MACCE (12.8% vs. 23.5%; P = 0.02) were lower with HCR; overall survival by Kaplan-Meier favored HCR (log-rank P = 0.0006).
Conclusions:
Despite longer hospitalization and higher costs, HCR was associated with superior long-term symptom relief and lower MACCE compared with PCI in high-risk MV-CAD. These findings support HCR as a viable strategy in carefully selected patients and warrant validation in prospective multicenter studies.
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