Comparing patient outcomes following minimally invasive coronary artery bypass grafting surgery vs. coronary artery bypass grafting: a single-center retrospective cohort study.

ABSTRACT

Background: This present research was designed for comparing coronary artery disease (CAD) patient outcomes following minimally invasive coronary artery bypass grafting surgery (MICS) or coronary artery bypass grafting (CABG). Methods: From 2014-2017, 679 CAD patients underwent MICS (n=281) or CABG (n=398) and were evaluated for the present study. Patient data were analyzed using 11 propensity score-matched assessment and a multivariate Cox proportional hazards regression model, and primary study achievements comprised major adverse cardiac and cerebrovascular events (MACCEs), myocardial infarction (MI), cardiac death, heart failure (HF), revascularization, and stroke. The median follow-up period was 2.68 years. Results: CABG patients exhibited a trend towards higher cumulative overall rates of MACCEs at 2 years (CABG 6.2% vs. MICS 3.8%) and 4 years (CABG 9.3% vs. MICS 7.6%) [adjusted hazard ratio (HR) 1.33; 95% confidence interval (CI) 0.33-5.39 for CABG vs. MICS; P=0.687], although this difference was not significant. No significant differences in 2- or 4-year cardiac death rates were observed between groups (CABG 3.5%, 5.6% vs. MICS 2.8%, 2.8%; adjusted HR 0.23; 95% CI 0.03-1.81 for CABG vs. MICS; P=0.160). Further, there existed no discrepancies in rates of MI (P=1.000), HF (adjusted HR 4.76; 95% CI 0.01-6.40 for CABG vs. MICS; P=0.996), stroke (adjusted HR 9.58; 95% CI 0.11-25.24 for CABG vs. MICS; P=0.320), or repeated revascularization (adjusted HR 1.71; 95% CI 0.01-7.21 for CABG vs. MICS; P=0.631) when comparing these patient groups. In a multivariable Cox proportional hazards regression analysis, patients that were male (adjusted HR 5.28; 95% CI 1.48-18.83; P=0.010) and cases with a history of previous MI epsiodes (adjusted HR 3.20; 95% CI 1.09-9.37; P=0.034) were found to be at a higher risk of MACCEs. Conclusions: Follow-up data indicated that the MICS and CABG treatments could achieve similar outcomes.