Introduction
Materials and methods
Search strategy and articles selection
Data extraction and endpoints
Sensitivity analysis on primary endpoints
Quality and publication bias assessment
Results
Search strategy and patient demographics
Study ID, year | Country | Study design | Patients, n MAG/SAG | Age, mean ± SD MAG/SAG | Female sex, n (%) MAG/SAG | EF, Mean ± SD, MAG/SAG | COPD, n (%) MAG/SAG | DM, n (%) MAG/SAG | Type of arterial grafts except for LITA, n (%) | OPCAB, n (%) MAG/SAG | Number of grafts, Mean ± SD MAG/SAG | Follow-up, Mean ± SD | NOS |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dewar 1995 [22] | Canada | R-PSM | 377/765 | 60 (32–83) | Totally 185 (16) | NR | NR | NR | RITA:100% | NR | NR | 7 | 8 |
Myers 2000 [38] | USA | RCT | 81/80 | 63/63 | 18 (64)/ 20 (64) | NR | NR | 11 (14)/12 (15) | RITA:100% | NR | NR | NR | – |
Cohen 2001 [20] | Canada | R-PSM | 478/ 956 | 61 ± 9/ 61 ± 9 | 76 (16)/152 (16) | NR | 23 (5)/40 (4) | 160 (34)/238 (25) | RA:100% | NR | 3 ± 1/3 ± 1 | 36 | 7 |
Muneretto 2003 [37] | Italy | RCT | 100/100 | 67 ± 9/68 ± 8 | 27 (27)/25 (25) | NR | 19 (19)/22 (22) | 41 (41)/40 (40) | RITA and RA | NR | 3 ± 1/3 ± 1 | 1 ± 0.3 | – |
Hirottani 2003 [51] | Japan | R | 179/124 | 65 ± 8/64 ± 9 | 42 (23)/31 (25) | 48 ± 15/49 ± 16 | NR | 179 (100)/124 (100) | RITA:100% | NR | 4 ± 1/3 ± 1 | 10 | 7 |
Calafiore 2004 [18] | Italy | R-PSM | 570/570 | 61 ± 8/ 61 ± 9 | 110 (19)/100 (18) | 59 ± 13/ 59 ± 14 | 16 (3)/17 (3) | 138 (24)/138 (24) | RITA:100% | 185 (33)/138 (24) | 3 ± 1/3 ± 1 | 7 ± 5 | 8 |
Lytle 2004 [36] | USA | R-PSM | 1152/ 1152 | 58 ± 8/ 58 ± 8 | 139 (12)/158 (14) | NR | NR | 137 (12)/141 (12) | RITA:100% | NR | NR | NR | 8 |
Lawton 2005 [32] | USA | R-PSM | 294/294 | 62 ± 10/64 ± 10 | 294 (100)/294 (100) | 48 ± 10/46 ± 12 | NR | 155 (53)/141 (48) | RA:100% | NR | NR | 4 ± 2/4 ± 2 | 8 |
Guru 2006 [28] | Canada | R-PSM | 5466/ 47,214 | NR | 875 (16)/9,915 (21) | NR | 383 (7)/3,777 (8) | 1,367 (25)/12,276 (26) | RITA and RA | NR | NR | 5/6 | 8 |
Carrier 2009 [19] | Canada | R | 1235 /5,420 | 61 ± 9/ 68 ± 8 | 199 (16)/ 1579 (29) | NR | NR | 254 (21)/ 1696 (31) | RITA:100% | NR | NR | 6 | 8 |
Nasso 2009 [39] | Italy | RCT | 611 / 205 | NR | 346 (57)/120 (59) | NR | 166 (27)/57 (28) | 228 (37)/78 (38) | NR | NR | NR | 3 | – |
Kurlansky 2010 [30] | USA | R-PSM | 2,215/ 2,369 | 62.9 ± 10/68 ± 9 | 329 (15)/608 (26) | NR | NR | 461 (21)/646 (27) | RITA:100% | NR | NR | 13 (6–32)/11 (6–3) | 8 |
Goldman 2011 [25] | USA | RCT | 366/367 | 61 ± 8/62 ± 8 | 1 (1)/ 5 (1) | NR | NR | 154 (42)/153 (42) | RA:100% | 41 (11)/48 (13) | NR | 5 | – |
Locker 2012 [34] | USA | R-PSM | 1187/ 7435 | 58 ± 9/68 ± 9 | 179 (15)/1844 (25) | 57 ± 11/55 ± 14 | (7)/(12) | (18)/(34) | RITA and RA | (3)/(4) | NR | 8 ± 5 | 7 |
Benedetto 2013 [13] | UK | R-PSM | 936/8069 | 65 ± 10/68 ± 9 | (20)/(18) | NR | (12)/(11) | (10)/(12) | RA:100% | (37.6)/(2.7) | 3 ± 1/3 ± 1 | 6 ± 4 | 8 |
Lin 2013 [33] | USA | R-PSM | 260/ 260 | 71 ± 9/ 71 ± 10 | 79 (30)/77 (30) | 54 ± 14/ 53 ± 16 | 33 (13)/39 (15) | 101 (39)/91 (34) | RA:100% | 43 (17)/47 (18) | 3 ± 1/3 ± 1 | 9 (6–12) | 8 |
Parsa 2013 [40] | USA | R | 728/16,881 | 59/64 | 144 (20)/ 4811 (29) | 0.5/0.5 | 28 (4)/1,384 (8) | 107 (15)/ 5,047 (30) | RITA:100% | NR | 3/3 | 25 | 7 |
Benedetto 2014 [14] | UK | R-PSM | 750/3445 | NR | (81)/(11) | NR | 58 (8)/365 (11) | 119 (16)/1086 (32) | RITA:100% | 538 (72)/2235 (65) | NR | 5 ± 3 | 8 |
Buxton 2014 [17] | Australia | R | 2988/ 786 | 65 ± 10/71 ± 8 | 572 (19)/193 (25) | NR | 114 (4)/26 (3) | 859 (29)/321 (41) | RITA and RA | NR | 3 ± 1/4 ± 1 | NR | 7 |
Garatti 2014 [23] | Italy | R-PSM | 209/243 | 48 ± 8/50 ± 7 | 10 (5)/10 (4) | 52 ± 9/ 52 ± 10 | 8 (4)/7 (3) | 31 (15)/34 (14) | RITA and RA | NR | 3 ± 1/4 ± 1 | 14 ± 3/14 ± 4 | 8 |
Mohammadi 2014 [53] | Canada | R-PSM | 111/111 | 56 ± 9/57 ± 10 | 12 (11)/ 14 (13) | 34 ± 5/ 32 ± 7 | 17 (15)/18 (16) | 17 (16)/18 (16) | RITA:100% | NR | NR | 20 | 8 |
Pullan 2014 [43] | UK | R-PSM | 2,940/ 7006 | 62 ± 62/65 ± 65 | NR | NR | NR | 1147 ± 39/2382 ± 34 | RA:100% | 1,999 ± 68 /1261 ± 18 | 3 ± 3/4 ± 3 | 7 ± 7/ 7 ± 7 | 8 |
Schwann 2014 [47] | USA | R-PSM | 2,794/2,794 | Similar | Similar | Similar | Similar | Similar | RA:100% | NR | Similar | NR | 8 |
Grau 2015 [27] | USA | R-PSM | 1,544/5,122 | NR | NR | NR | NR | NR | RITA:100% | NR | 4 ± 1/4 ± 1 | 15 | 8 |
Kinoshita 2015 [52] | Japan | R-PSM | 412/412 | 72 ± 8/72 ± 8 | 80 (19)/90 (22) | NR | 82 (20)/91 (22) | 245 (59)/233 (57) | RITA:100% | 100% | 4 ± 1/3 ± 1 | 12 | 8 |
LaPar 2015 [31] | USA | R-PSM | 1333/1,333 | 56 ± 10/ 59 ± 10 | 191 (14)/249 (19) | 0.6 [0.50–0.60]/ 0.6 [0.50–0.60] | NR | 243 (18)/465 (35) | RITA:100% | NR | 3 ± 3/3 ± 3 | NR | 7 |
Petrovic 2015 [41] | Serbia | RCT | 100/100 | 56 ± 6/57 ± 7 | 27 (27)/ 27 (27) | 49 ± 11/48 ± 11 | 9 (9)/8 (8) | 39 (39)/43 (43) | RA:100% | NR | 3 ± 1/ 3 ± 1 | 8 | – |
Raja 2015 [44] | UK | R-PSM | RA:779 /RITA: 747 | RA:62 RITA: 60 | RA:125 (16) RITA: 82 (11) | NR | RA:55 (7) RITA: 60 (8) | RA:242 (31) RITA: 120 (16) | RA:51% RITA:49% | NR | NR | 8 | 8 |
Schwann 2016 [48] | USA | R-PSM | 3736/4,484 | Similar | Similar | Similar | Similar | Similar | RA:82.8% RITA:17.2% | NR | Similar | 0–16 | 8 |
Yamaguchi 2016 [54] | Japan | R-PSM | 1309/1309 | Similar | Similar | Similar | Similar | Similar | RIMA:809 RA:224 | Similar | Similar | 12 | 8 |
Benedetto 2017 [15] | UK | R-PSM | 3,026/9606 | NR | 327 (11)/1773 (19) | NR | 127 (4)/769 (8) | 405 (13)/1773 (19) | RA:2,001 (66) RITA:755 (25) RITA + RA: 270 (9) | 1,818 (60)/4412 (46) | NR | 8 ± 5 | 8 |
Bisleri 2017 [16] | Italy | R-PSM | 315/201 | 77 ± 6/79 ± 7 | 89 (28)/61 (30) | NR | 58 (18)/24 (12) | 155 (49)/96 (48) | RITA: 131 (75) RA: NR | 62 (37)/36 (21) | 2.5 ± 0.5/2.6 ± 0.4 | 7 (0–10) | 8 |
Pu 2017 [42] | Canada | R-PSM | 5,580/14,496 | 60 ± 9/ 68 ± 9 | 586 (11)/ 2803 (19) | NR | 816 (15)/3028 (21) | 1,650 (30)/5771 (40) | RITA and RA | NR | NR | 4/4 | 8 |
DeSimone 2018 [21] | USA | R | 1482/ 46,502 | NR | 276 (19)/12,044 (26) | NR | 122 (8)/5,441 (12) | 239 (16)/15,857 (34) | RITA:100% | 142 (10)/4,464 (10) | NR | NR | 7 |
Goldstone 2018 [26] | USA | R-PSM | 5,866/ 53,566 | 62 ± 11/67 ± 10 | 863 (15)/13,636 (26) | 56 ± 12/52 ± 14 | NR | 2,077 (35)/24,481 (46) | RITA:1,570 (27%) RA:4,272 (73%) | NR | NR | 5.3 (4–7) | 8 |
Janiec 2018 [29] | Sweden | R | 1,898/ 46,343 | RA: 65 ± 10 RIMA: 64 ± 9/ 66 ± 8 | RA:277 (27) RIMA: 146 (17)/8879 (19) | NR | 98 (5)/2551 (7) | 418 (22)/ 11,077 (24) | RITA:862 (45) RA:1,036 (55) | 132 (7)/ 1,103 (2) | NR | RA:11 ± 4 RITA: 6 ± 5/ 9 ± 4 | 8 |
Luthra 2018 [35] | UK | R-PSM | 1238/ 2757 | 66 ± 10/66 ± 10 | 219 (18)/505 (18) | NR | 152 (12)/362 (13) | 342 (28)/724 (26) | RITA and RA | NR | 4 ± 1/4 ± 1 | 6/5 | 8 |
Rocha 2018 [45] | Canada | R-PSM | 8,629/ 8,629 | NR | NR | NR | NR | NR | RITA and RA | NR | NR | 4 | 7 |
Saraiva 2018 [46] | Portugal | R-PSM | 936/1488 | 59 ± 10/67 ± 9 | 124 (13)/336 (23) | NR | 52 (6)/93 (6) | 339 (36)/675 (45) | RITA:100% | 608 ± 65/381 ± 26 | NR | 5 | 8 |
Taggart 2019 [5]* | Multinational | RCT | 1548/1,554 | 64 ± 9/ 64 ± 9 | 230 (15)/216 (14) | NR | NR | 371 (24)/363 (23) | RITA:100% | NR | NR | 10 | – |
Tam 2020 [50] | Canada | R-PSM | 2,961/7954 | 66 ± 10/69 ± 9 | 2,961 (100)/7,954 (100) | NR | 237 (8)/865 (11) | 1373 (46)/3812 (48) | RITA and RA | 1190 (40)/ 893 (11) | 3 ± 1/3 ± 1 | 5 (3–8) | 8 |
Gaudino 2021 [24] | USA | R-PSM | 12,629/50,773 | 61 ± 10/66 ± 10 | 2101 (14)/13 146 (86) | NR | 412 (20)/ 3451 (26) | 898 (43)/ 6491 (49) | RITA and RA | 465 (22)/3062 (23) | NR | 6 (4–9) | 8 |
Taggart 2022 [49]* | Multinational | RCT-Post-hoc | 405/311 | 64 (58–69)/64 (57–70) | 74 (18)/62 (20) | NR | 30 (7)/17 (6) | 405 (100)/311 (100) | RITA:100% | NR | NR | 10 | |
Thuijs 2022 [6] | Multinational | RCT– Post-hoc | 465/ 1001 | 62 ± 10/67 ± 9 | 64 (14)/224 (22) | NR | 34 (7)/89 (9) | 141 (31)/361 (36) | RITA:73% RA:41% | 101 (22)/146 (15) | 3 ± 1/3 ± 1 | 13 | – |
Primary endpoints: OS and event-free OS
Secondary endpoints: RIMA vs RA as a second arterial conduit in terms of OS
Subgroup analyses
Endpoint | N | HR (Mantel–Haenszel) | 95% CI | p value |
---|---|---|---|---|
Unadjusted OS | 180,459 | 0.589 | 0.58–0.60 | < 0,0001 |
Adjusted OS | 80,036 | 0.706 | 0.69–0.73 | < 0,0001 |
Event-free OS | 47,376 | 0.828 | 0.80–0.86 | < 0,0001 |
OS RITA vs RA | 31,178 | 0.936 | 0.89–0.98 | 0,009 |
OS Age > 70 years | 1452 | 0.712 | 0.60–0.85 | 0.0003 |
OS Diabetes mellitus | 2516 | 0.656 | 0.57–0.75 | < 0,0001 |
OS Females | 14,834 | 0.889 | 0.84–0.94 | < 0.0001 |