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Death at 10 Years Similar With Bilateral-, Single-Artery CABG

WEDNESDAY, Jan. 30, 2019 -- There is no difference in the rate of death from any cause at 10 years for patients undergoing coronary artery bypass grafting (CABG) with bilateral or single internal-thoracic-artery grafting, according to a study published in the Jan. 31 issue of the New England Journal of Medicine.

David P. Taggart, M.D., from the John Radcliffe Hospital in Oxford, England, and colleagues randomly assigned patients scheduled for CABG to undergo bilateral or single internal-thoracic-artery grafting (1,548 and 1,554 patients, respectively).

The researchers found that 13.9 percent of patients in the bilateral-graft group received only a single internal-thoracic-artery graft, while 21.8 percent of patients in the single-graft group also received a radial-artery graft. In the intention-to-treat analysis, 20.3 and 21.2 percent of patients in the bilateral- and single-graft groups died from any cause (hazard ratio, 0.96; 95 percent confidence interval, 0.82 to 1.12; P = 0.62). Overall, 24.9 and 27.3 percent of patients in the bilateral-graft and single-graft groups, respectively, had an event with respect to the secondary outcome (composite of death, myocardial infarction, or stroke; hazard ratio, 0.90; 95 percent confidence interval, 0.79 to 1.03).

"When data from patients were analyzed according to the actual receipt of two or more arterial grafts, as compared with a single arterial graft (the as-treated analysis), there appeared to be a meaningful difference in mortality in favor of multiple arterial grafts," the authors write.

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Posted: January 2019

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