Meta-Analysis of Bilateral Versus Single Internal Thoracic Artery Grafting in Patients ≥70 Years of Age

• Published in: The American journal of cardiology 2022-06, Vol.173, p.48-55
• Main Authors: Mulder, BG Sibinga, Candura, Dario, Schoones, Jan W., Etnel, Jonathan R.G., Schouten, Geerten N., de Weger, Arend, Tomšič, Anton, Klautz, Robert J.M.
• Format: Article
• Language: English
• Subjects: Age; Blanking; Cardiovascular disease; Censorship; Complications; Confidence intervals; Coronary artery; Coronary Artery Bypass - adverse effects; Coronary Artery Disease; Coronary vessels; Digitization; Grafting; Heart attacks; Heart surgery; Humans; Infections; Life expectancy; Literature reviews; Mammary Arteries - transplantation; Meta-analysis; Morbidity; Mortality; Patients; Population (statistical); Propensity Score; Retrospective Studies; Risk Factors; Statistical analysis; Surgery; Systematic review; Thorax; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2022.02.052

The optimal choice of graft material in patients ≥70 years of age undergoing coronary artery bypass grafting remains unknown. A systematic review of literature was conducted by searching PubMed, Embase, Web of Science, and Cochrane Library databases for original publications that compared bilateral internal thoracic artery (BITA) grafting with single internal thoracic artery grafting in patients ≥70 years of age. Data were extracted by 2 independent investigators and meta-analyzed with the use of random effects. A total of 10 studies, including 11,185 patients, met the inclusion criteria. No differences in early mortality and morbidity, with the exemption of sternal wound complications which were more frequently observed in the BITA group (odds ratio 1.72, 95% 1.00 to 2.96 confidence interval [CI], p = 0.05; propensity score-matched population odds ratio 1.58, 95% CI 1.09 to 2.29, p = 0.02), were observed. Overall survival was superior in the overall patient population (hazard ratio [HR] 0.76, 95% CI 0.66 to 0.86, p