Author + information
- Received November 8, 2017
- Revision received January 10, 2018
- Accepted January 24, 2018
- Published online May 2, 2018.
- Mateusz Tajstra, MDa,∗ (, )
- Tomasz Hrapkowicz, MD, PhDb,
- Michał Hawranek, MD, PhDa,
- Krzysztof Filipiak, MD, PhDb,
- Marek Gierlotka, MDa,
- Marian Zembala, MDb,
- Mariusz Gąsior, MDa,
- Michael Oscar Zembala, MDb,
- on behalf of the POL-MIDES Study Investigators
- a3rd Chair and Department of Cardiology, SMDZ in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
- bDepartment of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
- ↵∗Address for correspondence:
Dr. Mateusz Tajstra, Silesian Center for Heart Diseases, Ul. M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
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)
- coronary artery bypass graft
- hybrid revascularization
- multivessel coronary artery disease
- percutaneous coronary intervention
The HYBRID study was supported by the Ministry of Science and Higher Education of Poland (Project of National Research and Development Center, number 13 008406). Dr. Michael Oscar Zembala is a consultant for Symetis/Boston Scientific, Abbott Inc., and AtriCure Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 8, 2017.
- Revision received January 10, 2018.
- Accepted January 24, 2018.
- 2018 American College of Cardiology Foundation
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