Abstract: Objective To systematically evaluate the long-term efficacy and complications of hybrid coronary artery revascularization (HCR) and coronary artery bypass grafting (CABG) in the treatment of the multiple coronary artery disease. Methods The databases of Embase, PubMed, Web of Science, Cochrane Central Registry of Controlled Trials (Central), Wanfang Data and China Knowledge Network were systematically searched. The documents that met the inclusion criteria were screened, and the odds ratio (OR) and 95% confidence interval (CI) were calculated. RevMan 5.3 software was used for meta-analysis. Results Nine articles were included in the study. A total of 4 030 subjects were included, of which 1 142 were treated with HCR and 2 888 were treated with conventional CABG. Postoperative mortality (OR=0.72, 95%CI: 0.54- 0.96) and major cardiovascular and cerebrovascular events (MACCE, OR=0.54, 95%CI: 0.35-0.82) were lower in HCR group than those of CABG group in the mid- and long-term follow-up. There were no significant differences in the revascularization (OR=0.90, 95%CI: 0.61-1.34) and the incidence of angina (OR=0.51, 95%CI:0.18-1.41) between the two groups. In the midterm follow-up, the incidence of MACCE was lower in the HCR group than that in the conventional group (OR=0.31, 95%CI: 0.15-0.66), while there were no significant differences in the mortality (OR=0.79, 95%CI: 0.52-1.22),revascularization (OR=0.90, 95%CI: 0.61-1.34) and the incidence of myocardial infarction angina (OR=0.71, 95%CI: 0.05- 9.46) between the two groups. In the long-term follow-up, the postoperative mortality (OR=0.67, 95%CI: 0.54-0.96) and the incidence of myocardial infarction angina (OR=0.32, 95%CI: 0.15-0.68) were significantly lower in HCR group than those of the CABG group. There were no significant differences in MACCE (OR=0.72, 95%CI: 0.43-1.21) and revascularization (OR= 0.93, 95%CI: 0.60-1.45) between the two groups. Conclusion Compared with CABG, HCR can reduce the medium-term MACCE, long-term all-cause mortality and myocardial infarction/angina pectoris in patients with multi-vessel coronary artery disease.

Key words: coronary artery disease, coronary artery bypass grafting, hybrid coronary revascularization, coronary artery multivessel disease, medium and long-term follow-up: Meta-analysis