Review ArticleAlternative Approaches to Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention, How Do They Compare? A Systematic Review and Meta-AnalysisEL-Andari, Ryaan MD*; Bozso, Sabin J. MD, PhD*; Fialka, Nicholas M. BSc†; Kang, Jimmy J. H. MD*; Hassanabad, Ali Fatehi MD, PhD‡; Nagendran, Jeevan MD, PhD* Author Information From the *Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada †Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada ‡Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada. Disclosure: The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.cardiologyinreview.com). Correspondence: Jeevan Nagendran, MD, PhD, FRCSC, Minimally Invasive and Transcatheter Valve Surgery, University of Alberta, Mazankowski Alberta Heart Institute, 4-108A Li Ka Shing Health Research Centre, 8602 – 112 Street, Edmonton, AB T6G 2E1. E-mail: [email protected]. Cardiology in Review ():10.1097/CRD.0000000000000524, January 23, 2023. | DOI: 10.1097/CRD.0000000000000524 Buy SDC PAP Metrics Abstract Coronary artery disease (CAD) is a leading cause of mortality worldwide. Severe symptomatic CAD is treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Alternative CABG (ACABG) approaches including thoracotomy, off-pump, total endoscopic, and robotic-assisted CABG are increasing in prevalence to address the increased early risk of CABG. This systematic review and meta-analysis aims to review the contemporary literature comparing outcomes after ACABG and PCI. Pubmed, Medline, and Embase were systematically searched by 2 authors for articles comparing the outcomes after ACABG and PCI. A total of 1154 articles were screened, and 11 were included in this review. The RevMan 5.4 software was used to perform a meta-analysis of the pooled data. Individual studies found rates of long-term survival, major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction (MI), and repeat revascularization either favored ACABG or did not differ significantly. Pooled estimates of the compiled data identified rates of MACCE, MI, and repeat revascularization favored ACABG. The results of this review demonstrated the favorable rates of long-term mortality, MACCE, MI, and repeat revascularization for ACABG in addition to similar short-term mortality and stroke when compared with PCI. Advancement of both CABG and PCI continues to improve patient outcomes. With the increasing prevalence of ACABG, similar studies will need to be undertaken with further direct comparisons between ACABG and PCI. Finally, hybrid revascularization should continue to be explored for its combined benefits of long-term outcomes, short-term safety, and ability to achieve complete revascularization. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.