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Abstract Introduction: The benefit of total arterial revascularization (TAR) in coronary artery bypass grafting (CABG) remains a controversial issue. This study sought to evaluate whether there is any difference on the long-term results of TAR and non-TAR CABG patients. Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL/CCTR), Clinical Trials.gov, Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Google Scholar databases were searched for studies published by October 2020. Randomized clinical trials and observational studies with propensity score matching comparing TAR versus non-TAR CABG were included. Random-effects meta-analysis was performed. The current barriers to implementation of TAR in clinical practice and measures that can be used to optimize outcomes were reviewed. Results: Fourteen publications (from 2012 to 2020) involving a total of 22,746 patients (TAR: 8,941 patients; non-TAR: 13,805 patients) were included. The pooled hazard ratio (HR) for long-term mortality (over 10 years) was lower in the TAR group than in the non-TAR group (random effect model: HR 0.676, 95% confidence interval 0.586-0.779, P<0.001). There was evidence of low heterogeneity of treatment effect among the studies for mortality, and none of the studies had a particular impact on the summary result. The result was not influenced by age, sex, or comorbidities. We identified low risk of publication bias related to this outcome. Conclusion: This review found that TAR presents the best long-term results in patients who undergo CABG. Given that many patients are likely to benefit from TAR, its use should be encouraged. Introduction (TAR (CABG issue longterm long term nonTAR non Methods MEDLINE, MEDLINE , (MEDLINE) EMBASE, EMBASE (EMBASE) CENTRAL/CCTR, CENTRALCCTR CENTRAL/CCTR CENTRAL CCTR (CENTRAL/CCTR) Trialsgov gov Trials.gov SciELO, SciELO (SciELO) LatinoAmericana Latino Americana LILACS, LILACS (LILACS) 2020 included Randomeffects Random effects metaanalysis meta analysis performed reviewed Results 201 22746 22 746 22,74 8941 8 941 8,94 13805 13 805 13,80 (HR over 1 years random model 0676 0 676 0.676 95 0.5860.779, 05860779 0.586 0.779, 586 779 0.586-0.779 P<0.001. P0001 P P<0.001 . 001 P<0.001) age sex comorbidities outcome Conclusion encouraged (MEDLINE (EMBASE (CENTRAL/CCTR (SciELO (LILACS 202 20 2274 2 74 22,7 894 94 8,9 1380 80 13,8 067 67 0.67 9 5860 0.5860.779 0586077 0586 0.58 0779 0.779 58 77 0.586-0.77 P000 P<0.00 00 227 7 22, 89 8, 138 13, 06 6 0.6 0.5860.77 058607 058 0.5 077 0.77 5 0.586-0.7 P00 P<0.0 0. 0.5860.7 05860 05 07 0.7 0.586-0. P0 P<0. 0.5860. 0.586-0 P<0 0.5860 0.586- P<