Association of Age With 10-Year Outcomes After Coronary Surgery in the Arterial Revascularization Trial. Academic Article uri icon

Overview

abstract

  • BACKGROUND: The association of age with the outcomes of bilateral internal thoracic arteries (BITAs) versus single internal thoracic arteries (SITAs) for coronary bypass grafting (CABG) remains to be determined. OBJECTIVES: The purpose of this study was to evaluate the association between age and BITA versus SITA outcomes in the Arterial Revascularization Trial. METHODS: The primary endpoints were all-cause mortality and a composite of major adverse events, including all-cause mortality, myocardial infarction, or stroke. Secondary endpoints were bleeding complications and sternal wound complications up to 6 months after surgery. Multivariable fractional polynomials analysis and log-rank tests were used. RESULTS: Age did not affect any of the explored outcomes in the overall BITA versus SITA comparison in the intention-to-treat analysis and in the analysis based on the number of arterial grafts received. However, when the intention-to-treat analysis was restricted to the populations of patients between age 50 and 70 years, younger patients in the BITA arm had a significantly lower incidence of major adverse events (p = 0.03). CONCLUSIONS: Our results suggest that BITA may improve long-term outcome in younger patients, although more randomized data are needed to confirm this hypothesis.

authors

  • Gaudino, Mario Fl
  • Di Franco, Antonino
  • Flather, Marcus
  • Gerry, Stephen
  • Bagiella, Emilia
  • Gray, Alastair
  • Pearcey, Leon
  • Saw, Teng-Hui
  • Lees, Belinda
  • Benedetto, Umberto
  • Fremes, Stephen E
  • Taggart, David P

publication date

  • January 5, 2021

Research

keywords

  • Coronary Artery Bypass
  • Internal Mammary-Coronary Artery Anastomosis

Identity

Scopus Document Identifier

  • 85098077784

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2020.10.047

PubMed ID

  • 33413936

Additional Document Info

volume

  • 77

issue

  • 1