ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
This article is part of the Research TopicCardiovascular Mechanobiology: Molecular Mechanisms, Disease Pathogenesis, and Therapeutic OpportunitiesView all 3 articles
Hybrid Coronary Revascularization vs. PCI in High-Risk Multivessel Coronary Artery Disease: A Two-Center, Two-Year Outcome Comparison
Provisionally accepted
- Wuhan Asia Heart Hospital, Wuhan, China
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Background — Treatment strategies for multivessel coronary artery disease (MV‑CAD) include percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and the increasingly adopted hybrid coronary revascularization (HCR). HCR combines minimally invasive left internal mammary artery (LIMA)–to–left anterior descending (LAD) grafting with PCI of non‑LAD lesions. However, comparative evidence in high‑risk MV‑CAD remains limited. Methods — We retrospectively analyzed 330 high‑risk MV‑CAD patients from two centers (HCR n=109; PCI n=221) over 2 years. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE: all‑cause death, stroke, myocardial infarction, repeat revascularization, and angina). Kaplan–Meier survival analysis and conventional statistical tests were applied. Results — Baseline demographics and SYNTAX scores were similar between groups. HCR involved fewer and shorter stents than PCI. Hospital stay, ICU duration, and total costs were higher with HCR. At 2 years, angina (5.5% vs. 17.2%; P=0.003) and MACCE (12.8% vs. 23.5%; P=0.02) were lower with HCR; overall survival by Kaplan–Meier favored HCR (log‑rank P=0.0006). Conclusions — Despite longer hospitalization and higher costs, HCR was associated with superior long‑term symptom relief and lower MACCE compared with PCI in high‑risk MV‑CAD. These findings support HCR as a viable strategy in carefully selected patients and warrant validation in prospective multicenter studies.
Keywords: hybrid coronary revascularization, Percutaneous Coronary Intervention, Multivessel coronary artery disease, MACCE, outcomes
Received: 07 Jul 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Yan, Luo, Yi, Qiu, Yang, Xiaodie, Song, Hua, Chen and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hua Yan, yanhua0807@aliyun.com
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