Mateusz Tajstra1, Tomasz Hrapkowicz2, Michał Hawranek3, Krzysztof Filipiak2, Marek Gierlotka3, Marian Zembala2, Mariusz Gąsior3, Michael Oscar Zembala2. 1. 3rd Chair and Department of Cardiology, SMDZ in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland. Electronic address: mateusztajstra@wp.pl. 2. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland. 3. 3rd Chair and Department of Cardiology, SMDZ in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland.
Abstract
OBJECTIVES: This study aimed to investigate the 5-year clinical follow-up of the HYBRID (Hybrid Revascularization for Multivessel Coronary Artery Disease) trial. BACKGROUND: The HYBRID trial, the only randomized study involving thorough analysis of outcome after the 2 procedures, suggested that hybrid coronary revascularization (HCR) is feasible in selected patients with multivessel coronary disease referred for conventional coronary artery bypass grafting (CABG). There are currently no long-term outcome data from randomized trials in this setting. METHODS: A total of 200 patients with multivessel coronary disease referred for conventional surgical revascularization were randomly assigned to undergo HCR or CABG. The primary endpoint was the occurrence of all-cause mortality at 5 years. RESULTS: Nine patients (4 in HCR and 5 in CABG group) were lost to the 5-year follow-up. Finally, 191 patients (94 in HCR and 97 in CABG group) formed the basis of this study. The groups were well balanced in terms of pre-procedural characteristics. All-cause mortality at 5-year follow-up was similar in the 2 groups (6.4% for HCR vs. 9.2% for CABG; p = 0.69). The rates of myocardial infarction (4.3% vs. 7.2%; p = 0.30), repeat revascularization (37.2% vs. 45.4%; p = 0.38), stroke (2.1% vs. 4.1%; p = 0.35), and major adverse cardiac and cerebrovascular events (45.2% vs. 53.4%; p = 0.39) were also similar in the 2 groups. CONCLUSIONS:HCR has similar 5-year all-cause mortality when compared with conventional coronary bypass grafting (Safety and Efficacy Study of Hybrid Revascularization in Multivessel Coronary Artery Disease; NCT01035567).
RCT Entities:
OBJECTIVES: This study aimed to investigate the 5-year clinical follow-up of the HYBRID (Hybrid Revascularization for Multivessel Coronary Artery Disease) trial. BACKGROUND: The HYBRID trial, the only randomized study involving thorough analysis of outcome after the 2 procedures, suggested that hybrid coronary revascularization (HCR) is feasible in selected patients with multivessel coronary disease referred for conventional coronary artery bypass grafting (CABG). There are currently no long-term outcome data from randomized trials in this setting. METHODS: A total of 200 patients with multivessel coronary disease referred for conventional surgical revascularization were randomly assigned to undergo HCR or CABG. The primary endpoint was the occurrence of all-cause mortality at 5 years. RESULTS: Nine patients (4 in HCR and 5 in CABG group) were lost to the 5-year follow-up. Finally, 191 patients (94 in HCR and 97 in CABG group) formed the basis of this study. The groups were well balanced in terms of pre-procedural characteristics. All-cause mortality at 5-year follow-up was similar in the 2 groups (6.4% for HCR vs. 9.2% for CABG; p = 0.69). The rates of myocardial infarction (4.3% vs. 7.2%; p = 0.30), repeat revascularization (37.2% vs. 45.4%; p = 0.38), stroke (2.1% vs. 4.1%; p = 0.35), and major adverse cardiac and cerebrovascular events (45.2% vs. 53.4%; p = 0.39) were also similar in the 2 groups. CONCLUSIONS: HCR has similar 5-year all-cause mortality when compared with conventional coronary bypass grafting (Safety and Efficacy Study of Hybrid Revascularization in Multivessel Coronary Artery Disease; NCT01035567).
Authors: Edward L Hannan; Yi-Feng Wu; Kimberly Cozzens; Jacqueline Tamis-Holland; Frederick S K Ling; Alice K Jacobs; Ferdinand J Venditti; Peter B Berger; Gary Walford; Spencer B King Iii Journal: J Geriatr Cardiol Date: 2021-03-28 Impact factor: 3.327
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