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Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting.

Publication ,  Journal Article
Gaudino, M; Audisio, K; Di Franco, A; Alexander, JH; Kurlansky, P; Boening, A; Chikwe, J; Devereaux, PJ; Diegeler, A; Dimagli, A; Flather, M ...
Published in: Eur J Cardiothorac Surg
June 15, 2022

OBJECTIVES: We used individual patient data from 4 of the largest contemporary coronary bypass surgery trials to evaluate differences in long-term outcomes when radial artery (RA), right internal thoracic artery (RITA) or saphenous vein graft (SVG) are used to complement the left internal thoracic artery-to-left anterior descending graft. METHODS: Primary outcome was all-cause mortality. Secondary outcome was a composite of major adverse cardiac and cerebrovascular events (all-cause mortality, myocardial infarction and stroke). Propensity score matching and Cox regression were used to reduce the effect of treatment selection bias and confounders. RESULTS: A total of 10 256 patients (1510 RITA; 1385 RA; 7361 SVG) were included. The matched population consisted of 1776 propensity score-matched triplets. The mean follow-up was 7.9 ± 0.1, 7.8 ± 0.1 and 7.8 ± 0.1 years in the RITA, RA and SVG cohorts respectively. All-cause mortality was significantly lower in the RA versus the SVG [hazard ratio (HR) 0.62, 95% confidence interval (CI): 0.51-0.76, P = 0.003] and the RITA group (HR 0.59, 95% CI 0.48-0.71, P = 0.001). Major adverse cardiac and cerebrovascular event rate was also lower in the RA group versus the SVG (HR 0.78, 95% CI 0.67-0.90, P = 0.04) and the RITA group (HR 0.75, 95% CI 0.65-0.86, P = 0.02). Results were consistent in the Cox-adjusted analysis and solid to hidden confounders. CONCLUSIONS: In this pooled analysis of 4 large coronary bypass surgery trials, the use of the RA was associated with better clinical outcomes when compared to SVG and RITA.

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Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

June 15, 2022

Volume

62

Issue

1

Location

Germany

Related Subject Headings

  • Treatment Outcome
  • Saphenous Vein
  • Retrospective Studies
  • Respiratory System
  • Radial Artery
  • Mammary Arteries
  • Humans
  • Coronary Artery Disease
  • Coronary Artery Bypass
  • 3201 Cardiovascular medicine and haematology
 

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Gaudino, M., Audisio, K., Di Franco, A., Alexander, J. H., Kurlansky, P., Boening, A., … Benedetto, U. (2022). Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting. Eur J Cardiothorac Surg, 62(1). https://doi.org/10.1093/ejcts/ezac345
Gaudino, Mario, Katia Audisio, Antonino Di Franco, John H. Alexander, Paul Kurlansky, Andreas Boening, Joanna Chikwe, et al. “Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting.Eur J Cardiothorac Surg 62, no. 1 (June 15, 2022). https://doi.org/10.1093/ejcts/ezac345.
Gaudino M, Audisio K, Di Franco A, Alexander JH, Kurlansky P, Boening A, et al. Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting. Eur J Cardiothorac Surg. 2022 Jun 15;62(1).
Gaudino, Mario, et al. “Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting.Eur J Cardiothorac Surg, vol. 62, no. 1, June 2022. Pubmed, doi:10.1093/ejcts/ezac345.
Gaudino M, Audisio K, Di Franco A, Alexander JH, Kurlansky P, Boening A, Chikwe J, Devereaux PJ, Diegeler A, Dimagli A, Flather M, Lamy A, Lawton JS, Tam DY, Reents W, Rahouma M, Girardi LN, Hare DL, Fremes SE, Benedetto U. Radial artery versus saphenous vein versus right internal thoracic artery for coronary artery bypass grafting. Eur J Cardiothorac Surg. 2022 Jun 15;62(1).
Journal cover image

Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

June 15, 2022

Volume

62

Issue

1

Location

Germany

Related Subject Headings

  • Treatment Outcome
  • Saphenous Vein
  • Retrospective Studies
  • Respiratory System
  • Radial Artery
  • Mammary Arteries
  • Humans
  • Coronary Artery Disease
  • Coronary Artery Bypass
  • 3201 Cardiovascular medicine and haematology