3rd Chair and Department of Cardiology, SMDZ in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland.
Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
JACC Cardiovasc Interv. 2018 May 14;11(9):847-852. doi: 10.1016/j.jcin.2018.01.271. Epub 2018 Apr 18.
This study aimed to investigate the 5-year clinical follow-up of the HYBRID (Hybrid Revascularization for Multivessel Coronary Artery Disease) trial.
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.
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.
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.
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).
本研究旨在探讨 HYBRID（多血管冠状动脉疾病的杂交血运重建）试验的 5 年临床随访结果。
HYBRID 试验是唯一一项对 2 种治疗方法后结局进行全面分析的随机研究，表明在接受传统冠状动脉旁路移植术（CABG）的多血管冠状动脉疾病患者中，行杂交血运重建（HCR）是可行的。目前在该治疗环境下尚无来自随机试验的长期结局数据。
共纳入 200 例因多血管冠状动脉疾病而拟行传统外科血运重建的患者，随机分配至行 HCR 或 CABG 治疗。主要终点为 5 年时全因死亡率。
9 例患者（HCR 组 4 例，CABG 组 5 例）在 5 年随访时失访。最终，191 例患者（HCR 组 94 例，CABG 组 97 例）纳入本研究。两组患者在术前特征方面具有良好的均衡性。两组患者在 5 年时的全因死亡率相似（HCR 组 6.4%，CABG 组 9.2%；p=0.69）。两组患者心肌梗死发生率（4.3% vs. 7.2%；p=0.30）、再次血运重建率（37.2% vs. 45.4%；p=0.38）、卒发生率（2.1% vs. 4.1%；p=0.35）和主要不良心脑血管事件发生率（45.2% vs. 53.4%；p=0.39）也相似。
与传统 CABG 相比，HCR 的 5 年全因死亡率相似（多血管冠状动脉疾病的杂交血运重建安全性和有效性研究；NCT01035567）。
