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General Thoracic and Cardiovascular Surgery

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Open Access 17-11-2022 | CABG | Review Article

Differences in long-term survival outcomes after coronary artery bypass grafting using single vs multiple arterial grafts: a meta-analysis with reconstructed time-to-event data and subgroup analyses

Authors: Dimitrios E. Magouliotis, Maria P. Fergadi, Prokopis-Andreas Zotos, Arian Arjomandi Rad, Andrew Xanthopoulos, Metaxia Bareka, Kyriakos Spiliopoulos, Thanos Athanasiou

Published in: General Thoracic and Cardiovascular Surgery | Issue 2/2023

Abstract

Objective

We reviewed the available literature on patients with coronary artery disease undergoing isolated coronary artery bypass grafting (CABG) with either single (SAG) or multiple arterial grafting (MAG).

Methods

Original research studies that evaluated the long-term survival of MAG versus SAG were identified, from 1995 to 2022. The median overall survival (OS) and event-free OS were the primary endpoints. Comparison of median OS between the right internal mammary artery (RIMA) and radial artery (RA) as a second arterial conduit was the secondary endpoint. Subgroup analyses were performed regarding patients older than 70 years, with diabetes mellitus, and females. A sensitivity analysis was performed with the leave-one-out method.

Results

Forty-four studies were included in the qualitative and thirty-nine in the quantitative synthesis. After pooling data from 180 to 459 patients, the MAG group demonstrated a higher OS (HR, 0.589; 95% CI, 0.58–0.60; p < 0.0001) and event-free OS compared with the SAG group (HR, 0.828; 95% CI, 0.80–0.86; p < 0.0001). In addition, RITA was associated with superior OS compared with RA as a second arterial conduit (HR, 0.936; 95% CI, 0.89–0.98; p = 0.009). MAG was also superior to SAG in patients over 70 years, females, and patients with diabetes mellitus. Sensitivity analysis demonstrated a small-size study effect on the female subgroup analysis.

Conclusion

The present meta-analysis indicates that MAG is associated with enhanced survival outcomes compared to SAG for patients undergoing isolated CABG.

Available only for authorised users

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Title: Differences in long-term survival outcomes after coronary artery bypass grafting using single vs multiple arterial grafts: a meta-analysis with reconstructed time-to-event data and subgroup analyses
Authors: Dimitrios E. Magouliotis
Maria P. Fergadi
Prokopis-Andreas Zotos
Arian Arjomandi Rad
Andrew Xanthopoulos
Metaxia Bareka
Kyriakos Spiliopoulos
Thanos Athanasiou
Publication date: 17-11-2022
Publisher: Springer Nature Singapore
Keywords: CABG
Diabetes
CABG
Published in: General Thoracic and Cardiovascular Surgery / Issue 2/2023
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-022-01891-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Differences in long-term survival outcomes after coronary artery bypass grafting using single vs multiple arterial grafts: a meta-analysis with reconstructed time-to-event data and subgroup analyses

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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