Robot-Assisted Coronary Artery Bypass Versus Percutaneous Coronary Intervention in Patients With Coronary Artery Disease: A Meta-Analysis
Mohamed Doma, Edmundo Damiani Bertoli, Gustavo Rovari, Adham Ramadan, Luena Seferasi, Mangesh Kritya, Ghazal Sanadgol, Ibrahim Kamel, Shanmukh Sai Pavan Lingamsetty, Yehia Karara, Lucas Cael Azevedo Ramos Bendaham, Motahar Hosseini, Arnar Geirsson, Chase R. Brown, Andrew M. GoldsweigObjective:
As alternatives to conventional coronary artery bypass grafting (CABG), robot-assisted CABG (R-CABG) and percutaneous coronary intervention (PCI) offer less invasive treatments for coronary artery disease (CAD). However, data comparing outcomes of R-CABG versus PCI are limited.
Methods:
Databases were systematically searched for studies comparing R-CABG versus PCI. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs), both overall and stratified by left main or multivessel (LM+MV) or isolated left anterior descending artery (LAD) disease. Kaplan–Meier curves were digitally extracted to reconstruct individual participant data (IPD), from which hazard ratios (HRs) were estimated for survival analyses.
Results:
Six retrospective studies, including 1,896 patients (R-CABG: 894, 47.1%), were analyzed. The mean age was 63.8 ± 11.3 years, and 78.7% were male patients. Follow-up ranged from 2 to 8 years. Overall, R-CABG was associated with a lower odds of target vessel revascularization (TVR; OR = 0.50, 95% CI: 0.27 to 0.93,
Conclusions:
R-CABG was associated with less TVR and MI compared with PCI in CAD patients, with no difference in all-cause mortality.