{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:38:01Z","timestamp":1790285881311,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Interventional Cardiology"],"published-print":{"date-parts":[[2020,1,3]]},"abstract":"<jats:p><jats:italic>Aim<\/jats:italic>. Optimal revascularization strategy in multivessel (MV) coronary artery disease (CAD) eligible for percutaneous management (PCI) and surgery remains unresolved. We evaluated, in a randomized clinical trial, residual myocardial ischemia (RI) and clinical outcomes of MV-CAD revascularization using coronary artery bypass grafting (CABG), hybrid coronary revascularization (HCR), or MV-PCI. <jats:italic>Methods<\/jats:italic>. Consecutive MV-CAD patients (<jats:italic>n<\/jats:italic>\u2009=\u2009155) were randomized (1\u2009:\u20091\u2009:\u20091) to conventional CABG (LIMA-LAD plus venous grafts) or HCR (MIDCAB LIMA-LAD followed by PCI for remaining vessels) or MV-PCI (everolimus-eluting CoCr stents) under Heart Team agreement on equal technical and clinical feasibility of each strategy. SPECT at 12 months (primary endpoint of RI that the trial was powered for; a measure of revascularization midterm efficacy and an independent predictor of long-term prognosis) preceded routine angiographic control. <jats:italic>Results<\/jats:italic>. Data are given, respectively, for the CABG, HCR, and MV-PCI arms. Incomplete revascularization rate was 8.0% vs. 7.7% vs. 5.7% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.71<\/mml:mn><\/mml:mrow><\/mml:math>). Hospital stay was 13.8 vs. 13.5 vs. 4.5 days (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), and sick-leave duration was 23 vs. 16 vs. 8 weeks (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>). At 12 months, RI was 5 (2, 9)% vs. 5 (3, 7)% vs. 6 (3, 10)% (median; Q1, Q3) with noninferiority <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>p<\/mml:mi><\/mml:math> values of 0.0006 (HCR vs. CABG) and 0.016 (MV-PCI vs. CABG). Rates of angiographic graft stenosis\/occlusion or in-segment restenosis were 20.4% vs. 8.2% vs. 5.9% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:mrow><\/mml:math>). Clinical target vessel\/graft failure occurred in 12.0% vs. 11.5% vs. 11.3% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.62<\/mml:mn><\/mml:mrow><\/mml:math>). Major adverse cardiac and cerebral event (MACCE) rate was similar (12% vs. 13.4% vs. 13.2%; <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.83<\/mml:mn><\/mml:mrow><\/mml:math>). <jats:italic>Conclusion<\/jats:italic>. In this first randomized controlled study comparing CABG, HCR, and MV-PCI, residual myocardial ischemia and MACCE were similar at 12 months. There was no midterm indication of any added value of HCR. Hospital stay and sick-leave duration were shortest with MV-PCI. While longer-term follow-up is warranted, these findings may impact patient and physician choices and healthcare resources utilization. This trial is registered with <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01699048\">NCT01699048<\/jats:ext-link>.<\/jats:p>","DOI":"10.1155\/2020\/5458064","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T18:31:20Z","timestamp":1578076280000},"page":"1-11","source":"Crossref","is-referenced-by-count":50,"title":["Randomized Clinical Trial of Surgical vs. Percutaneous vs. Hybrid Revascularization in Multivessel Coronary Artery Disease: Residual Myocardial Ischemia and Clinical Outcomes at One Year\u2014Hybrid coronary REvascularization Versus Stenting or Surgery (HREVS)"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9704-7678","authenticated-orcid":true,"given":"Vladimir","family":"Ganyukov","sequence":"first","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Kochergin","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandr","family":"Shilov","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Tarasov","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Skupien","sequence":"additional","affiliation":[{"name":"Jagiellonian University School of Medicine, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Szot","sequence":"additional","affiliation":[{"name":"Jagiellonian University School of Medicine, Krakow, Poland"},{"name":"Dept. of Nuclear Medicine, John Paul II Hospital, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-0636","authenticated-orcid":true,"given":"Aleksandr","family":"Kokov","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vadim","family":"Popov","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution A. 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Vishnevsky Institute of Surgery, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirill","family":"Kozyrin","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Barbarash","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Barbarash","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cResearch Institute for Complex Issues of Cardiovascular Diseases\u201d, Kemerovo, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0202-5987","authenticated-orcid":true,"given":"Piotr","family":"Musialek","sequence":"additional","affiliation":[{"name":"Jagiellonian University School of Medicine, Krakow, Poland"},{"name":"Jagiellonian University Dept. of Cardiac & Vascular Diseases, John Paul II Hospital, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"issue":"38","key":"1","first-page":"2624","volume":"35","year":"2014","journal-title":"European Heart Journal"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy855"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx437"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(96)90107-5"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt016"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.05.025"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1097\/imi.0000000000000355"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27098"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.114.009479"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.093"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa013563"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.5114\/wiitm.2017.66803"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.743963"},{"issue":"7","key":"14","first-page":"1107","volume":"47","year":"2006","journal-title":"Journal of Nuclear Medicine"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.09.008"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0804626"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2008.07.002"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.032"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.029"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1415447"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1412168"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.3705"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.117.027659"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.060"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.10.017"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1007\/s12350-011-9468-7"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.01.019"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.14864"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx512"},{"issue":"5","key":"30","first-page":"21","volume":"7","year":"2018","journal-title":"Cardiology\u2014Today\u2019s Intervention"}],"container-title":["Journal of Interventional Cardiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/jitc\/2020\/5458064.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jitc\/2020\/5458064.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jitc\/2020\/5458064.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T18:31:23Z","timestamp":1578076283000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/jitc\/2020\/5458064\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,3]]},"references-count":30,"alternative-id":["5458064","5458064"],"URL":"https:\/\/doi.org\/10.1155\/2020\/5458064","relation":{},"ISSN":["0896-4327","1540-8183"],"issn-type":[{"value":"0896-4327","type":"print"},{"value":"1540-8183","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,3]]}}}