ABC | Volume 110, Nº4, April 2018

Original Article Dong et al Comparison between HCR and OPCAB Arq Bras Cardiol. 2018; 110(4):321-330 Table 2 – Short-term and mid-term clinical outcomes of the included studies References Time of outcomes HCR OPCAB Number of patients MACCE Death Stroke MI TVR Number of patients MACCE Death Stroke MI TVR Kon 18 Short-term 15 0 0 0 0 0 30 7 0 1 6 0 Mid-term 15 1 0 0 0 1 30 7 0 0 0 0 Vassiliades 19 Short-term 91 1 0 1 0 0 4175 126 74 47 20 12 Mid-term 91 10 1 1 1 7 4175 -- 230 -- -- -- Hu 20 Short-term 104 0 0 0 0 0 104 0 0 0 0 0 Mid-term 104 1 0 0 0 1 104 10 1 5 0 3 Halkos 21 Short-term 147 3 1 1 1 0 588 12 5 4 3 0 Mid-term 147 -- -- -- -- 13 588 -- -- -- -- 18 Halkos 22 Short-term 27 0 0 0 0 0 81 4 3 0 2 0 Mid-term 27 -- -- -- -- 2 81 -- -- -- -- 1 Bachinsky 23 Short-term 25 0 0 0 0 0 27 1 1 0 0 0 Zhou 24 Short-term 141 7 1 1 5 0 141 10 2 1 7 0 Harskamp 25 Short-term 33 1 1 0 0 0 32 1 1 0 0 0 Mid-term 33 1 1 0 0 2 32 2 1 0 1 1 Song 26 Mid-term 120 8 3 0 0 5 237 19 6 8 2 6 HCR: hybrid coronary revascularization, OPCAB: Off-pump coronary artery bypass grafting, MACCE: major adverse cardiac and cerebrovascular event, MI: myocardial infarction, TVR: target vessel revascularization. Table 3 – Summary of results for short-term clinical outcomes of HCR versus OPCAB Outcomes Number of studies Total numbers of patients SMD or RR 95% CI p value Short-term MACCE rate 8 5761 0.55 [0.30, 1.03] 0.06 Staged HCR 4 5161 0.58 [0.23, 1.47] 0.25 Simultaneous HCR 4 600 0.54 [0.23, 1.23] 0.14 Short-term mortality 8 5761 0.51 [0.17, 1.48] 0.22 Staged HCR 4 5161 0.46 [0.12, 1.73] 0.25 Simultaneous HCR 4 600 0.66 [0.11, 3.88] 0.64 Short-term stroke 8 5761 0.93 [0.28, 3.05] 0.90 Operation time 3 542 1.29 [0.54, 2.05] < 0.001 Ventilator time 6 1861 -0.36 [-0.55, -0.16] < 0.001 ICU stay 7 1913 -0.35 [-0.58, -0.13] 0.002 Hospital stay 7 1538 -0.29 [-0.50, -0.07] 0.01 Blood transfusion rate 6 1361 0.57 [0.49, 0.67] < 0.001 AF rate 7 1933 1.08 [0.83, 1.40] 0.56 Hospitalization costs 3 305 1.06 [0.45, 1.66] < 0.001 HCR: hybrid coronary revascularization, OPCAB: Off-pump coronary artery bypass grafting, MACCE: major adverse cardiac and cerebrovascular event, AF: atrial fibrillation, SMD: standardized mean difference, RR: relative risk, CI: confidence interval. surgical procedures (8-10 cm thoracotomy incisions), different kinds of DES (cypher or taxus), uncertainty of baseline LVEF (not reported) and high heterogeneity in analysis. We also put three recent high-quality studies into pooled data so that all outcomes are updated. In addition, in the present study, we focus on postoperative complications and take stroke as a primary endpoint. Therefore, the present analysis is needed for a better elucidation of HCR and OPCAB. To our knowledge, this is the first meta-analysis comparing the mid-term clinical outcomes between HCR and OPCAB so far. Our data shows that HCR has a lower mid-term MACCE rate while OPCAB shows a better result in mid-term TVR. Moreover, no significant difference in mid-term mortality was detected between the two groups. Patients undergoing the hybrid procedure have relatively better mid-term clinical outcomes probably owing to reducedmyocardial manipulation 325