Improved Outcomes of Total Arterial Myocardial Revascularization in Elderly Patients at Long-Term Follow-Up: A Propensity-Matched Analysis

Bisleri, Gianluigi; Bacco, Lorenzo Di; Turturiello, Dario; Mazzoletti, Angelica; Giroletti, Laura; Repossini, Alberto; Muneretto, Claudio

doi:10.1016/j.athoracsur.2016.06.028

Cited by 10 publications

(15 citation statements)

References 13 publications

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“…Studies were excluded for the following reasons: no comparison between TAR and non‐TAR strategy (n = 32), sample population derived from a previously published and included series (n = 1), and lack of propensity score matching (n = 1). Consequently, 18 articles were included in our study . Mean age and mean body mass index of the included populations were 65.6 years (±7.6) and 27.1 (±1.7).…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, 10 described a BIMA usage of ≥80%. For this reason, they were assigned to the category “TAR with BIMA” . The remaining 4 studies were categorized as “TAR without BIMA” (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…All but two studies (Bisleri 2016, Bisleri 2017) showed a mean number of anastomosis ≥3 per patient. The two exceptions reported 2.4 and 2.5 anastomosis per patient respectively (Table S1).…”

Section: Resultsmentioning

confidence: 99%

“…These studies were assigned to the group “two arteries in TAR”. The remaining nine studies showed ≥2.50 arterial conduits and therefore, they were assigned to the “three arteries in TAR” group. The number of arterial conduits per patient in these nine studies were: Bisleri 2017 = 2.52, Buxton 2012 = 3.03, Buxton 2014 = 2.81, Formica = 3.00, Garatti = 3.20, Mohammadi = 3.00, Nasso = 3.10, Shi = 3.12, and Suzuki = 3.45 …”

Section: Resultsmentioning

confidence: 99%

“…Consequently, 18 articles were included in our study. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Mean age and mean body mass index of the included populations were 65.6 years (±7.6) and 27.1 (±1.7). Thirty percent of the population presented with diabetes and 18.9% were female patients (Table S1).…”

Section: Resultsmentioning

confidence: 99%

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Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

et al. 2019

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Background and Aim of the Study We explored the current evidence available on total arterial revascularization (TAR) carrying out a meta‐analysis of propensity score‐matched studies comparing TAR versus non‐TAR strategy. Methods PubMed, EMBASE, and Google Scholar were searched for propensity score‐matched studies comparing TAR vs non‐TAR. The generic inverse variance method was used to compute the combined hazard ratio (HR) of long‐term mortality. The Der‐Simonian and Laird method were used to compute the combined risk ratio (RR) of 30‐day mortality, deep sternal wound infection, and reoperation for bleeding. Results Eighteen TAR vs non‐TAR matched populations were included. Meta‐analysis showed a significant benefit in terms of long‐term survival of the TAR group over the non‐TAR group (HR: 0.73; 95% confidence interval [CI]: 0.68‐0.78). Better long‐term survival over non‐TAR strategy was confirmed by both subgroups: TAR with the bilateral internal mammary artery (BIMA) and TAR without BIMA. Meta‐regression suggests that TAR may offer a higher protective survival effect in diabetic patients (coefficient: −0.0063; 95% CI: −0.01 to 0.0006), when carried out with BIMA (coefficient: −0.15; 95% CI: −0.27 to −0.03) or using three arterial conduits (coefficient: −0.12; 95% CI: −0.25 to 0.007). A TAR strategy carried out using BIMA, differently from TAR without BIMA, increases the risk of deep sternal infection (RR: 1.44; 95% CI: 1.17‐1.77). Conclusions TAR provides a long‐term survival benefit compared with the non‐TAR strategy. Also, compared with TAR without BIMA, TAR with BIMA may offer a higher protective long‐term survival effect at the expense of a higher risk of sternal deep wound infection.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

et al. 2019

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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

Magouliotis

Fergadi

Zotos

et al. 2022

Gen Thorac Cardiovasc Surg

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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.

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Long-term follow-up of total arterial versus conventional and hybrid myocardial revascularization: A propensity score matched analysis

Bacco

Repossini

Tespili

et al. 2019

Cardiovascular Revascularization Medicine

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Improved Outcomes of Total Arterial Myocardial Revascularization in Elderly Patients at Long-Term Follow-Up: A Propensity-Matched Analysis

Cited by 10 publications

References 13 publications

Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

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

Long-term follow-up of total arterial versus conventional and hybrid myocardial revascularization: A propensity score matched analysis

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