Total arterial coronary bypass graft surgery is associated with better long-term survival in patients with multivessel coronary artery disease: a systematic review with meta-analysis

Abstract Introduction: The benefit of total arterial revascularization (TAR) in coronary artery bypass grafting (CABG) remains a controversial issue. This study sought to evaluate whether there is any difference on the long-term results of TAR and non-TAR CABG patients. Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL/CCTR), Clinical Trials.gov, Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Google Scholar databases were searched for studies published by October 2020. Randomized clinical trials and observational studies with propensity score matching comparing TAR versus non-TAR CABG were included. Random-effects meta-analysis was performed. The current barriers to implementation of TAR in clinical practice and measures that can be used to optimize outcomes were reviewed. Results: Fourteen publications (from 2012 to 2020) involving a total of 22,746 patients (TAR: 8,941 patients; non-TAR: 13,805 patients) were included. The pooled hazard ratio (HR) for long-term mortality (over 10 years) was lower in the TAR group than in the non-TAR group (random effect model: HR 0.676, 95% confidence interval 0.586-0.779, P<0.001). There was evidence of low heterogeneity of treatment effect among the studies for mortality, and none of the studies had a particular impact on the summary result. The result was not influenced by age, sex, or comorbidities. We identified low risk of publication bias related to this outcome. Conclusion: This review found that TAR presents the best long-term results in patients who undergo CABG. Given that many patients are likely to benefit from TAR, its use should be encouraged.

Características antropométricas e diagnósticos dos pacientes com queixa de baixa estatura encaminhados ao ambulatório de crescimento de um Hospital Universitário / The anthropometric profile and diagnoses of patients who were referred tothe growth ambulatory of a University Hospital complaining about short stature

Objetivo: Investigar o perfil antropométrico de crianças que foram encaminhadas ao ambulatório decrescimento de um hospital universitário no período de 01 de setembro de 2001 a 26 de fevereiro de 2003.Métodos: Trata-se de um estudo investigativo, retrospectivo e predominantemente quantitativo, no qualforam selecionados 101 pacientes. Foram pesquisados dados como idade na primeira consulta, altura e peso de nascimento, peso e altura da primeira consulta, IMC e diagnóstico final. Resultados: A média de idade na primeira consulta foi de 8,7 anos no grupo masculino e 9,3 no feminino. Em relação ao diagnóstico, 45% dos pacientes do sexo masculino foram considerados como variantes do normal para baixa estatura, 16% estavam em vigilância de crescimento, 29% tinham mais de um diagnóstico, 4% tinham baixa estatura por uma causa orgânica e 6% eram considerados eutróficos. Entre as pacientes do sexo feminino, 51% tinham diagnóstico de variante de normalidade, 11% estavam em vigilância de crescimento, 33% tinham mais de um diagnóstico e 5% tinham baixa estatura por causa orgânica. Quanto ao IMC, 15,7% dos meninos e 15,5% das meninas tinham valores maiores do que 2 desvios padrão. Foi diagnosticado só um caso de obesidade no grupo masculino. Conclusão: os dados encontrados neste trabalho estão em concordância com o que está relatado na literatura.

Objective: To investigate the anthropometric profile of children who were referred to the growth outpatientclinic of a University Hospital from September 1st 2001 to February 26th 2003. Methods: An investigative,retrospective, and quantitative study was performed with 101 patients. Data concerned to the age of firstvisit, birth weight and length, body weight and length on the first visit, BMI, and final diagnosis wereinvestigated. Results: The average age of the first visit was 8.7 years in the male group and 9.3 in the femalegroup. In the male group 15% were diagnosed as having normal short stature, 16% were on growth surveillance,29% had more than one diagnosis, 4% had short stature as a result of organic cause, and 6% were eutrophic.In the female group 51% were diagnosed with an average short stature, 11% were on growth surveillance,33% had more than one diagnosis, and 5% had short stature as a result of organic cause. The male children(15.7%) had a BMI bigger than -2 SD as well as 15.5% of the female children. Obesity was found in one malepatient. Conclusion: The data found on this study agrees with data found in literature.