Background/Objectives: Few studies have analyzed in-hospital complications and events following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) procedures for patients who underwent these interventions for single-vessel coronary artery disease (CAD). This study aims to compare the outcomes of PCI and CABG in such patients using a large propensity-matched real-world database based on procedural codes. Methods: Adult patients receiving PCI or CABG for single-vessel CAD were identified from the 2016–2020 National Inpatient Sample (NIS) database. Any cases targeting multi-vessel disease or employing a multi-treatment approach were excluded using appropriate procedural codes. Differences in events and complications from admission to discharge were studied between the two procedures (PCI vs. CABG) via logistic regression analysis. Results: After propensity matching with 273,380 patients in both groups, complication risks such as cardiac tamponade (aOR: 3.6 [3.27–3.96]), acute kidney injury (aOR: 1.53 [1.51–1.56]), cardiogenic shock (aOR: 1.38 [1.34–1.40]), procedural bleeding (aOR: 1.75 [1.67–1.83]), acute ischemic stroke (aOR: 1.89 [1.80–1.97]), and all-cause mortality (aOR: 1.05 [1.02–1.08]) were higher among CABG patients. No differences were observed for events of cardiac perforation (aOR: 0.92, [0.84–1.01]). Conclusions: In this large real-world propensity-matched analysis, CABG was associated with higher risks of multiple in-hospital complications and all-cause mortality compared to PCI following a single-vessel coronary intervention.

Background: Excessive perioperative bleeding remains a major challenge in non-cardiac thoracic surgeries. Antifibrinolytic therapy can enhance hemostasis and reduce transfusion requirements, although its use carries a theoretical risk of postoperative thromboembolic complications that warrants evaluation alongside its hemostatic benefits. Main text: Methods: For this systematic review and meta-analysis, we searched multiple databases for studies that compared antifibrinolytic therapy with placebo or no intervention in adult patients undergoing non-cardiac thoracic surgery. Primary outcomes included intraoperative and early postoperative bleeding and blood transfusion requirements. Additionally, thromboembolic events, length of hospital and ICU stay, respiratory complications, and all-cause postoperative mortality were also analyzed. Standardized mean differences (SMDs), mean differences (MDs), or odds ratios (ORs) with 95% confidence intervals (CIs) were used for pooled estimates, while the I² statistic was used to assess heterogeneity. Results: Fifteen studies were included. Antifibrinolytics significantly reduced postoperative 24-hour (SMD − 1.04, 95% CI − 1.64 to − 0.43) and 12-hour (SMD − 1.06, 95% CI − 2.22 to 0.10) blood loss, intraoperative blood loss (SMD − 0.48, 95% CI − 1.05 to 0.08), total RBC transfusion (SMD − 0.54, 95% CI − 0.80 to − 0.28) and duration of hospital stay (MD − 0.96 days, 95% CI − 1.84 to − 0.08). IV route reduced 24-hour blood loss same topical, and aprotinin shortened hospital stay. Sensitivity analyses confirmed robustness, while meta regression identified publication year as a key moderator, explaining 19% of variance. No significant differences were observed for ICU stay, hemoglobin levels, thromboembolic events, respiratory complications, or mortality. Conclusions: Perioperative antifibrinolytic therapy in non-cardiac thoracic surgery improves hemostatic control, reduces transfusion requirements, and shortens hospitalization, with no significant increase in thromboembolic, respiratory, or mortality outcomes observed; however, these safety analyses were based on a limited number of studies and should be interpreted with caution.