Hybrid coronary revascularization vs. CABG for multivessel CAD: New meta-analysis tracks long-term outcomes
Hybrid coronary revascularization (HCR) and coronary artery bypass grafting (CABG) are associated with comparable long-term mortality rates among patients with multivessel coronary artery disease (MVCAD), according to new data published in the American Journal of Cardiology.[1] However, HCR patients were more likely to experience certain adverse events.
HCR, as the name suggests, is a combination of two different revascularization techniques. It includes both minimally invasive for the left anterior descending (LAD) coronary artery and traditional percutaneous coronary intervention (PCI) for non-LAD lesions.
“Previous studies showed the short-term benefits of HCR, including comparable mortality, reduced lengths of intubation and hospital stay, and less transfusion than CABG,” wrote first author Junichi Shimamura, MD, with the division of cardiothoracic surgery at Westchester Medical Center in New York, and colleagues. “However, the current guidelines do not recommend HCR as a routine procedure. This is partly because the previous analyses were based on retrospective data, and there is a lack of randomized controlled trials and meta-analyses in a large population with a long-term outcome.”
Shimamura et al. tracked data from 13 different studies comparing the two techniques. The mean patient age was 64.3 years old, and the mean follow-up period was 5.1 years.
Overall mortality was not significantly different different between the two treatment options. Repeat revascularization was more likely after HCR, the group noted, as were major adverse cardiac and cerebrovascular events (MACCEs).
The difference in MACCE rate was primarily seen in the first five years after the procedure was performed. After those initial five years, the MACCE risk was comparable between the two treatments. The increased repeat revascularization risk for HCR, meanwhile, was seen no matter how many years after treatment had passed.
“Even longer follow-ups and outcomes stratified by surgical and anatomical risk are warranted to select optimal coronary revascularization strategies, including HCR,” the authors wrote.
Click here to read the full analysis.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.