Comparison of hybrid coronary revascularization versus conventional Coronary Artery Bypass surgery in patients with multi-vessel coronary artery disease in a real-world setting: In-hospital outcomes and medium-term follow-up: COHOS study.
{"title":"Comparison of hybrid coronary revascularization versus conventional Coronary Artery Bypass surgery in patients with multi-vessel coronary artery disease in a real-world setting: In-hospital outcomes and medium-term follow-up: COHOS study.","authors":"Dhamodaran Kaliyamoorthy, Meeranghani Mohamed Yusuf, Vadivelu Ramalingam, Abhishek Kasha, Manickam Kathiresan, Rizwan Suliankatchi Abdulkader, Jeyashree Kathiresan, Aishwarya Mahesh Kumar, Elsa Grace, Anirban Choudhury","doi":"10.1016/j.ihj.2025.03.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this observational study was to evaluate the in-hospital and medium-term outcomes of hybrid coronary revascularization (HCR) in the real-world setting compared to conventional coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>All patients with multi-vessel coronary artery disease (MV-CAD) who underwent conventional CABG and HCR in our institution between January 2018 to January 2021 were evaluated in terms of length of intensive care unit (ICU), in-hospital stay, repeat revascularization rates, bleeding, stroke, and in-hospital mortality. Clinical outcomes (mortality and major adverse cardiac and cerebrovascular events [MACCE]) were assessed at average follow up of 3.6 years.</p><p><strong>Results: </strong>Pre-procedural characteristics were balanced between the groups after propensity score matching. There was no significant difference in MACCE [Odds ratio: 0.57; 95 % CI: 0.05 to 1.52; p = 0.66], in-hospital mortality [n = 2 (1.9 %) vs n = 0; p = 0.80], post procedure stroke [n = 2 (1.9 %) vs n = 2 (3.7 %); p = 0.86], post-procedural myocardial infarction requiring repeat revascularization [n = 2 (1.9 %) versus n = 1 (1.9 %); p = 1] during the in-hospital stay of the patients in the CABG vs HCR groups respectively. HCR was associated with significantly lower requirement for blood transfusions, bleeding risk, in-hospital stay, and intensive care unit stay. Analysis of the outcomes after 3.6 years revealed no significant difference in MACCE [Odds ratio: 1.40; 95 % CI: 0.46 to 4.30; p = 0.55], and post discharge mortality [n = 0 vs n = 0; p = 1]. Both groups had similar rates of post-procedural myocardial infarction requiring repeat revascularization [n = 0 vs n = 4 (7.4 %); p = 0.278], and rate of re-intervention [n = 0 vs n = 3 (5.6 %); p = 0.41].</p><p><strong>Conclusion: </strong>HCR may be considered as a safe and feasible alternative to conventional CABG in selected individuals with MV-CAD.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian heart journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.ihj.2025.03.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: The aim of this observational study was to evaluate the in-hospital and medium-term outcomes of hybrid coronary revascularization (HCR) in the real-world setting compared to conventional coronary artery bypass grafting (CABG).
Methods: All patients with multi-vessel coronary artery disease (MV-CAD) who underwent conventional CABG and HCR in our institution between January 2018 to January 2021 were evaluated in terms of length of intensive care unit (ICU), in-hospital stay, repeat revascularization rates, bleeding, stroke, and in-hospital mortality. Clinical outcomes (mortality and major adverse cardiac and cerebrovascular events [MACCE]) were assessed at average follow up of 3.6 years.
Results: Pre-procedural characteristics were balanced between the groups after propensity score matching. There was no significant difference in MACCE [Odds ratio: 0.57; 95 % CI: 0.05 to 1.52; p = 0.66], in-hospital mortality [n = 2 (1.9 %) vs n = 0; p = 0.80], post procedure stroke [n = 2 (1.9 %) vs n = 2 (3.7 %); p = 0.86], post-procedural myocardial infarction requiring repeat revascularization [n = 2 (1.9 %) versus n = 1 (1.9 %); p = 1] during the in-hospital stay of the patients in the CABG vs HCR groups respectively. HCR was associated with significantly lower requirement for blood transfusions, bleeding risk, in-hospital stay, and intensive care unit stay. Analysis of the outcomes after 3.6 years revealed no significant difference in MACCE [Odds ratio: 1.40; 95 % CI: 0.46 to 4.30; p = 0.55], and post discharge mortality [n = 0 vs n = 0; p = 1]. Both groups had similar rates of post-procedural myocardial infarction requiring repeat revascularization [n = 0 vs n = 4 (7.4 %); p = 0.278], and rate of re-intervention [n = 0 vs n = 3 (5.6 %); p = 0.41].
Conclusion: HCR may be considered as a safe and feasible alternative to conventional CABG in selected individuals with MV-CAD.
期刊介绍:
Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.