3.2.1. Primary outcome: Graft patency
Overall, 1191 patients were included in the present meta-analysis, with
an average of 1.79 (95% CI: 1.55–2.00) grafts per patient. ITA, RA or
GEA, and SV conduits were used, however exact numbers of each graft type
and graft target vessels were incompletely reported. Patency assessment
at follow-up was performed using either invasive angiography or
non-invasive computed tomographic angiography, and significative
coronary stenosis (>70%) or occlusions were considered non
patent grafts. Of the 32 studies, 15 arm level papers were included to
perform the Bayesian network meta-analysis, with a total of 1441 grafts
with 324 significative stenosis/occlusions [30-33, 39, 41-44, 47, 49,
53-54, 57, 59]. Mean follow-up for coronary angiography across studies
was 92.19 months (follow-up: min 3 – max 264 months). For the primary
outcome we compared patency of ITAs, SV and other arteries (GEA and RA)
at follow-up. Patency rates at follow-up for ITAs, SV and other arteries
are 87.82±12.41%, 65.98%±27.84% and 77.63±22.75%, respectively. The
network model, trace plot and density plot for graft patency are shown
in Supplementary Figures 1 and 2.
Summary results for all grafts patency at follow up are shown in Figure
2A, with SV used as reference. These pooled results show that ITAs and
other arteries (GEA and RA) are superior to SV. Rank probability
analysis for graft patency follow-up demonstrates that ITA had higher
probabilities of being the first most effective treatment (Figure 2B).
The efficacy of different treatments in terms of graft patency at
follow-up using HR and corresponding 95% CrI is displayed in Figure
3. Pairwise comparisons for graft
patency at follow-up are shown in Supplementary Figures 3A, 3B and 3C.
I2 demonstrated that heterogeneity was low for SV
versus ITA comparison and was moderate for SV and ITA versus other
arteries (GEA and RA). After comparison of
consistency and inconsistency
models through individual data points’ posterior mean deviance
contributions we conclude that there is a lack of evidence to suggest
inconsistency within the network (Supplementary Figure 4).