Key result
Adjunctive coronary endarterectomy with CABG decreased graft patency compared to isolated CABG (OR 0.43; 95% CI 0.29-0.63; P<0.0001).
Why the study?
Does adjunctive coronary endarterectomy decrease graft patency compared to isolated CABG in patients undergoing coronary artery bypass grafting?
Meta-Analysis (n=7,301)
Does adjunctive coronary endarterectomy decrease graft patency compared to isolated CABG in patients undergoing coronary artery bypass grafting?
Odds Ratio: 0.43 (95% CI 0.29–0.63)
p-value: p=<0.0001
Adjunctive coronary endarterectomy during CABG is associated with significantly decreased graft patency compared to isolated CABG.
Adjunctive CE during CABG compromises graft patency; challenges routine adjunctive use and supports selective application only.
OBJECTIVES: This meta-analysis aims to assess the graft patency quantitatively and statistically. METHODS: Eleven observational studies were identified by systematic literature search, incorporating 3311 patients undergoing coronary endarterectomy (CE) + coronary artery bypass graft (CABG) and 3990 undergoing isolated CABG, which were analysed using random-effects modelling. Heterogeneity, quality of scoring and risk of bias were assessed and reangiographic outcomes were documented. RESULTS: Adjunctive CE decreased graft patency [odds ratios = 0.43, 95% confidence interval [0.29-0.63], z = 4.33, P < 0.0001] with moderate heterogeneity, while the baseline demographics differed considerably. CONCLUSIONS: Whether CE remains a viable option to CABG requires novel studies collecting corresponding data from bench to bedside. To achieve satisfactory efficacy, surgeons should carefully weigh possible benefits and adverse effects of CE and prepare the surgical strategy adequately.
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Song et al. (2017) conducted a meta-analysis in Coronary artery disease requiring CABG (n=7,301). Coronary endarterectomy (CE) + coronary artery bypass graft (CABG) vs. Isolated CABG was evaluated on Graft patency (OR 0.43, 95% CI 0.29-0.63, p=<0.0001). Adjunctive coronary endarterectomy with CABG decreased graft patency compared to isolated CABG (OR 0.43; 95% CI 0.29-0.63; P<0.0001).
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