Hybrid coronary revascularization versus percutaneous coronary intervention: A systematic review and meta-analysis

Graphical abstract

Highlights • Hybrid coronary revascularization (HCR) for multivessel disease (MVD) is emerging. • This meta-analysis compared HCR to percutaneous coronary intervention (PCI) • Both procedures had comparable 30-day outcomes. • HCR had less myocardial infarction and target vessel revascularization at follow-up. • More randomized controlled trials comparing both approaches are needed.

Background Hybrid coronary revascularization (HCR) is an emerging approach for multivessel coronary artery disease (MVD) which combines the excellent long-term outcomes of surgery with the early recovery and reduced short-term complications of percutaneous coronary intervention (PCI). Here, we evaluated the effectiveness of HCR compared to PCI in patients with MVD. Methods A systematic database search in PubMed/MEDLINE, Embase, Scopus, and CENTRAL/CCTR was conducted by June 2021. Random-effects meta-analysis was performed, comparing major adverse cardiac and cerebrovascular events (MACCE) at 30 days and at latest follow-up between patients undergoing HCR versus PCI. Results A total of 27,041 patients (HCR: 939 patients, PCI: 26,102 patients) were included from seven studies published between 2013 and 2021. At latest follow-up, HCR was associated with lower rates of myocardial infarction (OR 0.40, 95% CI 0.20–0.80, p = 0.010) and target vessel revascularization (OR 0.49, 95% CI 0.37–0.64, p