{"id":"30a2da9a0bab","type":"article","url":"https://hartvaat.nl/2017/03/14/drie-arteriele-grafts-verbeteren-langetermijnoverleving-meta-analyse-van-propens/","title":"Drie arteriële grafts verbeteren langetermijnoverleving: meta-analyse van propensity-matched studies","title_en":"Three Arterial Grafts Improve Late Survival: A Meta-Analysis of Propensity-Matched Studies.","category":"preventie","category_label":"Preventie","professions":["cardioloog"],"tags":["bloeddrukbehandeling","figaro-dkd","perifeer-vaatlijden"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.116.025453","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.116.025453","authors":["Mario Gaudino","John D Puskas","Antonino Di Franco","Lucas B Ohmes","Mario Iannaccone","Umberto Barbero","David Glineur","Juan B Grau","Umberto Benedetto","Fabrizio D'Ascenzo","Fiorenzo Gaita","Leonard N Girardi","David P Taggart"],"significance":7,"published":"2017-03-14","source_date":"2017-03-14","image":"","kennis":[],"congress":"","summary_en":"This meta-analysis of propensity-matched studies showed that using three arterial grafts in CABG improves long-term survival compared with conventional strategies using fewer arterial conduits, supporting a more aggressive arterial revascularization approach.","created":"2026-07-03T10:26:36Z","updated":"2026-07-03T13:25:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse die aantoont dat gebruik van drie arteriële grafts bij CABG de langetermijnoverleving verbetert vergeleken met conventionele strategieën. Onderbouwt maximale arteriële revascularisatie.","abstract_original":"BACKGROUND: Little evidence shows whether a third arterial graft provides superior outcomes compared with the use of 2 arterial grafts in patients undergoing coronary artery bypass grafting. A meta-analysis of all the propensity score-matched observational studies comparing the long-term outcomes of coronary artery bypass grafting with the use of 2-arterial versus 3-arterial grafts was performed. METHODS: A literature search was conducted using MEDLINE, EMBASE, and Web of Science to identify relevant articles. Long-term mortality in the propensity score-matched populations was the primary end point. Secondary end points were in-hospital/30-day mortality for the propensity score-matched populations and long-term mortality for the unmatched populations. In the matched population, time-to-event outcome for long-term mortality was extracted as hazard ratios, along with their variance. Statistical pooling of survival (time-to-event) was performed according to a random effect model, computing risk estimates with 95% confidence intervals. RESULTS: Eight propensity score-matched studies reporting on 10 287 matched patients (2-arterial graft: 5346; 3-arterial graft: 4941) were selected for final comparison. The mean follow-up time ranged from 37.2 to 196.8 months. The use of 3 arterial grafts was not statistically associated with early mortality (hazard ratio, 0.93; 95% confidence interval, 0.71-1.22; P=0.62). The use of 3 arterial grafts was associated with statistically significantly lower hazard for late death (hazard ratio, 0.8; 95% confidence interval, 0.75-0.87; P<0.001), irrespective of sex and diabetic mellitus status. This result was qualitatively similar in the unmatched population (hazard ratio, 0.57; 95% confidence interval, 0.33-0.98; P=0.04). CONCLUSIONS: The use of a third arterial conduit in patients with coronary artery bypass grafting is not associated with higher operative risk and is associated with superior long-term survival, irrespective of sex and diabetic mellitus status."}