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. 2025 Jan 10;12(1):21.
doi: 10.3390/jcdd12010021.

Risk Factors for Coronary Events After Robotic Hybrid Off-Pump Coronary Revascularization

Aleksander Dokollari  1   2 , Beatrice Bacchi  3 , Serge Sicouri  1 , Francesco Cabrucci  1 , Massimo Bonacchi  3 , Danielle Spragan  1   4 , Mary Ann C Wertan  4 , Nitin Ghorpade  2 , Stephanie Kjelstrom  1 , Georgia Montone  1 , Yoshiyuki Yamashita  1   4 , Basel Ramlawi  1   4 , Francis Sutter  4
Affiliations

Risk Factors for Coronary Events After Robotic Hybrid Off-Pump Coronary Revascularization

Aleksander Dokollari et al. J Cardiovasc Dev Dis. .

Abstract

Objectives: The impact of long-term complications after robotic hybrid coronary revascularization (HCR), including persistent angina, repeat revascularization, and myocardial infarction (MI), remains limited. This study aims to determine the risk factors for coronary events after robotic HCR and their time-varying effects on outcomes.

Methods: We identified all consecutive patients who underwent robotic HCR at our institution. Baseline characteristics were explored as possible risk factors for angina, MI, and repeat revascularization with stents at any time during the follow-up.

Results: A total of 875 patients (mean age 71.1 ± 11.1 years) were included. After a median follow-up of 3.32 years (IQR 1.18-6.34 years), angina occurred in 134 patients (15.3%), repeat revascularization with stents in 139 patients (15.8%), and MI in 36 patients (4.1%). The hazard rates for all outcomes increased with follow-up time, with a notable early rise around two years of follow-up for angina and, to a lesser extent, repeat revascularization. The risk factors were the lack of radial artery graft use, black race, diabetes, obesity, chronic obstructive pulmonary disease, low ejection fraction <50%, severe left main coronary artery stenosis (>50%), and more than three-vessel disease.

Conclusions: Optimization of modifiable periprocedural risk factors may positively impact long-term prognosis in patients undergoing robotic HCR.

Keywords: coronary artery bypass graft; myocardial revascularization; percutaneous coronary revascularization; robotic cardiac surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves with all-cause death (A), MACCE (B), MI (C), Stroke (D), Repeat Revascularization (E), and Angina (F).
Figure 2
Figure 2
Periprocedural Risk Predictors for All-cause Death and MACCE. *—risk factor; **—important risk factor; ***—extremely important risk factor.
Figure 3
Figure 3
Periprocedural Risk Predictors for MI and Stroke. *—risk factor; **—important risk factor; ***—extremely important risk factor.
Figure 4
Figure 4
Periprocedural Risk Predictors for Repeat Revascularization and Angina. *—risk factor; **—important risk factor; ***—extremely important risk factor.
See this image and copyright information in PMC

References

    1. Makikallio T., Holm N.R., Lindsay M., Spence M.S., Erglis A., Menown I.B., Trovik T., Eskola M., Romppanen H., Kellerth T., et al. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): A prospective, randomized, open-label, non-inferiority trial. Lancet. 2016;388:2743–2752. doi: 10.1016/S0140-6736(16)32052-9. - DOI - PubMed
    1. Stone G.W., Kappetein A.P., Sabik J.F., Pocock S.J., Morice M.-C., Puskas J., Kandzari D.E., Karmpaliotis D., Brown W.M., Lembo N.J., et al. Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease. N. Engl. J. Med. 2019;381:1820–1830. doi: 10.1056/NEJMoa1909406. - DOI - PubMed
    1. Orbach A., Halon D.A., Jaffe R., Rubinshtein R., Karkabi B., Flugelman M.Y., Zafrir B. Impact of diabetes and early revascularization on the need for late and repeat procedures. Cardiovasc. Diabetol. 2018;17:25. doi: 10.1186/s12933-018-0669-0. - DOI - PMC - PubMed
    1. Head S.J., Mack M.J., Holmes D.R., Mohr F.W., Morice M.C., Serruys P.W., Kappetein A.P. Incidence, predictors, and outcomes of incomplete revascularization after percutaneous coronary intervention and coronary artery bypass grafting: A subgroup analysis of 3-year SYNTAX data. Eur. J. Cardiothorac. Surg. 2012;41:535–541. doi: 10.1093/ejcts/ezr105. - DOI - PubMed
    1. Hannan E.L., Wu Y., Cozzens K., Sundt T.M., III, Girardi L., Chikwe J., Wechsler A., Smith C.R., Gold J.P., Lahey S.J., et al. Hybrid Coronary Revascularization Versus Conventional Coronary Artery Bypass Surgery: Utilization and Comparative Outcomes. Circ. Cardiovasc. Interv. 2020;13:e009386. doi: 10.1161/CIRCINTERVENTIONS.120.009386. - DOI - PubMed

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