Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis

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 R...

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Main Authors: Qiuju Ding, Qingqing Zhu, Lichong Lu, Xiaofeng Cheng, Min Ge
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1555242/full
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author Qiuju Ding
Qingqing Zhu
Lichong Lu
Xiaofeng Cheng
Xiaofeng Cheng
Min Ge
author_facet Qiuju Ding
Qingqing Zhu
Lichong Lu
Xiaofeng Cheng
Xiaofeng Cheng
Min Ge
author_sort Qiuju Ding
collection DOAJ
description 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.
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spelling doaj-art-60e10ffeffc64b45903b77e1e7d94ea32025-08-20T02:10:39ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-03-011210.3389/fcvm.2025.15552421555242Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysisQiuju Ding0Qingqing Zhu1Lichong Lu2Xiaofeng Cheng3Xiaofeng Cheng4Min Ge5Department of Cardio-thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Cardio-thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Cardio-thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Cardio-thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, ChinaDepartment of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Cardio-thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, ChinaObservational 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.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1555242/fullmultiple arterial graft (MAG)single arterial graft (SAG)coronary artery bypass graft (CABG)randomized controlled trials (RCTs)survival
spellingShingle Qiuju Ding
Qingqing Zhu
Lichong Lu
Xiaofeng Cheng
Xiaofeng Cheng
Min Ge
Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis
Frontiers in Cardiovascular Medicine
multiple arterial graft (MAG)
single arterial graft (SAG)
coronary artery bypass graft (CABG)
randomized controlled trials (RCTs)
survival
title Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis
title_full Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis
title_fullStr Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis
title_full_unstemmed Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis
title_short Comparison of multiple arterial grafts vs. single arterial graft in coronary artery bypass surgery: a systematic review and meta-analysis
title_sort comparison of multiple arterial grafts vs single arterial graft in coronary artery bypass surgery a systematic review and meta analysis
topic multiple arterial graft (MAG)
single arterial graft (SAG)
coronary artery bypass graft (CABG)
randomized controlled trials (RCTs)
survival
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1555242/full
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