Data Sheet 1_Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis.pdf

Observational studies and randomised controlled trials (RCTs) have yielded conflicting results regarding the outcomes of multiple arterial grafts (MAG) vs. single arterial grafts (SAG) in coronary artery bypass graft (CABG) surgery. We conducted a comprehensive search across multiple databases for RCTs that directly compared MAG and SAG. The clinical outcomes assessed included all-cause mortality, cardiac-specific mortality, myocardial infarction (MI), repeat revascularization, stroke, sternal wound complications, and major bleeding. Outcomes were measured using hazard ratios (HR), relative risks (RR), and the corresponding 95% confidence intervals (CI). Eighteen RCTs involving 10,143 patients were included in the analysis. The follow-up period ranged from 6 months to 12.6 years, and the average age of the patients across the studies ranged between 56.3 and 77.3 years. MAG and SAG did not differ significantly in terms of the incidence of sternal wound complications, major bleeding, or stroke following CABG. However, the MAG group demonstrated a lower risk of all-cause mortality, cardiac mortality, MI, and repeat revascularization compared with the SAG group. MAG was associated with higher survival, lower risk of MI, and fewer repeat revascularization. Nonetheless, there were no significant differences in the incidence of sternal wound infections, major bleeding, and stroke between MAG and SAG.

关于冠状动脉旁路移植术（Coronary Artery Bypass Graft, CABG）中多动脉移植（Multiple Arterial Grafts, MAG）与单动脉移植（Single Arterial Grafts, SAG）的手术结局，观察性研究与随机对照试验（Randomised Controlled Trials, RCTs）所得结论存在分歧。本研究通过多数据库全面检索直接对比MAG与SAG的RCT研究。本研究评估的临床结局包括全因死亡率、心源性死亡率、心肌梗死（Myocardial Infarction, MI）、再次血运重建、脑卒中、胸骨切口并发症及大出血事件。结局指标通过风险比（Hazard Ratio, HR）、相对危险度（Relative Risk, RR）以及对应的95%置信区间（Confidence Interval, CI）进行量化分析。最终共纳入18项RCT研究，涉及10143名受试者。各研究的随访时长介于6个月至12.6年之间，受试者平均年龄跨度为56.3岁至77.3岁。CABG术后，MAG组与SAG组在胸骨切口并发症、大出血事件及脑卒中的发生率上无显著差异。但与SAG组相比，MAG组的全因死亡、心源性死亡、心肌梗死及再次血运重建风险均更低。MAG与更高的生存率、更低的心肌梗死风险及更少的再次血运重建操作相关。尽管如此，MAG组与SAG组在胸骨切口感染、大出血事件及脑卒中的发生率上仍无显著差异。