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

Background: Hybrid coronary revascularization (HCR) is an emerging approach for multivessel coronary artery disease (MVD) which combines the excellent long-term outcomes of surgery with the early recovery and reduced short-term complications of percutaneous coronary intervention (PCI). Here, we eval...

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Autores principales:	Jef Van den Eynde, Michel Pompeu Sá, Senne De Groote, Andrea Amabile, Serge Sicouri, Basel Ramlawi, Gianluca Torregrossa, Wouter Oosterlinck
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Hybrid coronary revascularization Percutaneous coronary Intervention Meta-analysis Clinical outcomes Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/b377f631661649d6b46a50316f9a5c9d
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spelling	oai:doaj.org-article:b377f631661649d6b46a50316f9a5c9d2021-12-02T05:02:10ZHybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis2352-906710.1016/j.ijcha.2021.100916https://doaj.org/article/b377f631661649d6b46a50316f9a5c9d2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352906721002049https://doaj.org/toc/2352-9067Background: Hybrid coronary revascularization (HCR) is an emerging approach for multivessel coronary artery disease (MVD) which combines the excellent long-term outcomes of surgery with the early recovery and reduced short-term complications of percutaneous coronary intervention (PCI). Here, we evaluated the effectiveness of HCR compared to PCI in patients with MVD. Methods: A systematic database search in PubMed/MEDLINE, Embase, Scopus, and CENTRAL/CCTR was conducted by June 2021. Random-effects meta-analysis was performed, comparing major adverse cardiac and cerebrovascular events (MACCE) at 30 days and at latest follow-up between patients undergoing HCR versus PCI. Results: A total of 27,041 patients (HCR: 939 patients, PCI: 26,102 patients) were included from seven studies published between 2013 and 2021. At latest follow-up, HCR was associated with lower rates of myocardial infarction (OR 0.40, 95% CI 0.20–0.80, p = 0.010) and target vessel revascularization (OR 0.49, 95% CI 0.37–0.64, p < 0.001), while the difference for MACCE did not reach statistical significance (OR 0.46, 95% CI 0.20–1.05, p = 0.061). No differences were observed in terms of 30-day outcomes, nor rates of mortality or stroke at latest follow-up. Conclusions: HCR might be a valid alternative to multivessel PCI, demonstrating a lower incidence of MI and TVR. Center experience, well-coordinated heart team discussions, and good patient selection likely remain essential to ensure optimal outcomes. Future comparative studies are required to define the optimal target population.Jef Van den EyndeMichel Pompeu SáSenne De GrooteAndrea AmabileSerge SicouriBasel RamlawiGianluca TorregrossaWouter OosterlinckElsevierarticleHybrid coronary revascularizationPercutaneous coronary InterventionMeta-analysisClinical outcomesDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Cardiology: Heart & Vasculature, Vol 37, Iss , Pp 100916- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hybrid coronary revascularization Percutaneous coronary Intervention Meta-analysis Clinical outcomes Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Hybrid coronary revascularization Percutaneous coronary Intervention Meta-analysis Clinical outcomes Diseases of the circulatory (Cardiovascular) system RC666-701 Jef Van den Eynde Michel Pompeu Sá Senne De Groote Andrea Amabile Serge Sicouri Basel Ramlawi Gianluca Torregrossa Wouter Oosterlinck Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis
description	Background: Hybrid coronary revascularization (HCR) is an emerging approach for multivessel coronary artery disease (MVD) which combines the excellent long-term outcomes of surgery with the early recovery and reduced short-term complications of percutaneous coronary intervention (PCI). Here, we evaluated the effectiveness of HCR compared to PCI in patients with MVD. Methods: A systematic database search in PubMed/MEDLINE, Embase, Scopus, and CENTRAL/CCTR was conducted by June 2021. Random-effects meta-analysis was performed, comparing major adverse cardiac and cerebrovascular events (MACCE) at 30 days and at latest follow-up between patients undergoing HCR versus PCI. Results: A total of 27,041 patients (HCR: 939 patients, PCI: 26,102 patients) were included from seven studies published between 2013 and 2021. At latest follow-up, HCR was associated with lower rates of myocardial infarction (OR 0.40, 95% CI 0.20–0.80, p = 0.010) and target vessel revascularization (OR 0.49, 95% CI 0.37–0.64, p < 0.001), while the difference for MACCE did not reach statistical significance (OR 0.46, 95% CI 0.20–1.05, p = 0.061). No differences were observed in terms of 30-day outcomes, nor rates of mortality or stroke at latest follow-up. Conclusions: HCR might be a valid alternative to multivessel PCI, demonstrating a lower incidence of MI and TVR. Center experience, well-coordinated heart team discussions, and good patient selection likely remain essential to ensure optimal outcomes. Future comparative studies are required to define the optimal target population.
format	article
author	Jef Van den Eynde Michel Pompeu Sá Senne De Groote Andrea Amabile Serge Sicouri Basel Ramlawi Gianluca Torregrossa Wouter Oosterlinck
author_facet	Jef Van den Eynde Michel Pompeu Sá Senne De Groote Andrea Amabile Serge Sicouri Basel Ramlawi Gianluca Torregrossa Wouter Oosterlinck
author_sort	Jef Van den Eynde
title	Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis
title_short	Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis
title_full	Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis
title_fullStr	Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis
title_full_unstemmed	Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis
title_sort	hybrid coronary revascularization versus percutaneous coronary intervention: a systematic review and meta-analysis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b377f631661649d6b46a50316f9a5c9d
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Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis

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