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

Journal of Cardiac Surgery
Stefano UrsoFrancisco Portela

Abstract

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. 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. 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....Continue Reading

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Citations

Apr 20, 2020·Journal of Cardiac Surgery·Stefano UrsoFrancisco Portela
Apr 20, 2020·Journal of Cardiac Surgery·Tomoyuki Kawada
Sep 1, 2021·The Journal of Thoracic and Cardiovascular Surgery·Francesco FormicaFrancesco Nicolini
Aug 31, 2021·Journal of the American College of Surgeons·Francesco FormicaStefano D'Alessandro

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