Total Arterial Coronary Bypass Graft Surgery is Associated with Better Long-Term Survival in Patients with Multivessel Coronary Artery Disease: a Systematic Review with Meta-Analysis

Autor: Sérgio C. Rayol, Jef Van den Eynde, Luiz Rafael P. Cavalcanti, Antonio Carlos Escorel Neto, Arian Arjomandi Rad, Andrea Amabile, Wilson Botelho Filho, Arjang Ruhparwar, Konstantin Zhigalov, Alexander Weymann, Dario Celestino Sobral Filho, Michel Pompeu B. O. Sá
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Brazilian Journal of Cardiovascular Surgery, Vol 36, Iss 1, Pp 78-85 (2021)
Druh dokumentu: article
ISSN: 1678-9741
04993934
DOI: 10.21470/1678-9741-2020-0653
Popis: Abstract Introduction: The benefit of total arterial revascularization (TAR) in coronary artery bypass grafting (CABG) remains a controversial issue. This study sought to evaluate whether there is any difference on the long-term results of TAR and non-TAR CABG patients. Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL/CCTR), Clinical Trials.gov, Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Google Scholar databases were searched for studies published by October 2020. Randomized clinical trials and observational studies with propensity score matching comparing TAR versus non-TAR CABG were included. Random-effects meta-analysis was performed. The current barriers to implementation of TAR in clinical practice and measures that can be used to optimize outcomes were reviewed. Results: Fourteen publications (from 2012 to 2020) involving a total of 22,746 patients (TAR: 8,941 patients; non-TAR: 13,805 patients) were included. The pooled hazard ratio (HR) for long-term mortality (over 10 years) was lower in the TAR group than in the non-TAR group (random effect model: HR 0.676, 95% confidence interval 0.586-0.779, P
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