Radial artery grafting in women improves 15-year survival

Dimitrova, Kamellia R.; Hoffman, Darryl M.; Geller, Charles M.; Ko, Wilson; Lucido, David; Dincheva, Gabriela R.; Tranbaugh, Robert F.

doi:10.1016/j.jtcvs.2012.10.004

Cited by 35 publications

(30 citation statements)

References 24 publications

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“…The use of radial artery grafts in woman undergoing CABG did not influence operative survival but significantly improved 5-year outcomes [37]. Others have also demonstrated improved intermediate and long-term survival in woman with the use of 2 or more arterial grafts [38]. However, despite these known survival benefits, ITAs and radial arteries remain underused in women [26,37,39].…”

Section: Commentmentioning

confidence: 99%

Impact of Gender on Arterial Revascularization Strategies for Coronary Artery Bypass Grafting

Jabagi

Tran

Hessian

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 99%

Impact of Gender on Arterial Revascularization Strategies for Coronary Artery Bypass Grafting

Jabagi

Tran

Hessian

et al. 2018

The Annals of Thoracic Surgery

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“…Arterial grafts are recommended. Indeed, the use of a radial artery graft has been proven to improve survival compared with use of a saphenous vein graft [52]. …”

Section: Cardiovascular Risk In Postmenopausal Womenmentioning

confidence: 99%

Coronary Heart Disease in Postmenopausal Women with Type II Diabetes Mellitus and the Impact of Estrogen Replacement Therapy: A Narrative Review

Boukhris

Tomasello

Marzà

et al. 2014

International Journal of Endocrinology

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Coronary heart disease is the main cause of death in postmenopausal women (PMW); moreover its mortality exceeds those for breast cancer in women at all ages. Type II diabetes mellitus is a major cardiovascular risk factor and there is some evidence that the risk conferred by diabetes is greater in women than in men. It was established that the deficiency of endogenous estrogens promotes the atherosclerosis process. However, the impact of estrogen replacement therapy (ERT) on cardiovascular prevention remains controversial. Some authors strongly recommend it, whereas others revealed a concerning trend toward harm. This review tries to underlines the different components of cardiovascular risk in diabetic PMW and to define the place of ERT.

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“…Furthermore, as women demonstrated lower graft patency among non-ITA grafts, it could be argued that women may be more likely to benefit from both ITAS and RA. Dimitrova and colleagues 29 found a significant survival benefit at 15 years among women receiving RA instead of SVG. Moreover, MAR is less likely performed among women and patency rates of arterial grafts were not significantly different between sexes but SVG patency was lower in women.…”

Section: Discussionmentioning

confidence: 99%

Long-term clinical outcome and graft patency of radial artery and saphenous vein grafts in multiple arterial revascularization

Ruttmann

Dietl

Feuchtner

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective: The long-term benefits of multiple arterial revascularization (MAR) in coronary artery bypass grafting remain uncertain. The aim of this study was to investigate the clinical outcome, graft patency, and need for subsequent target revascularization of radial artery (RA) versus saphenous vein graft in patients undergoing MAR in both patient-and graft-specific analyses.Methods: Between 2001 and 2016, we followed 1654 patients over a median of 7.4 years in a prospective, longitudinal study. Major adverse cardiac and cerebrovascular events, graft patency, and need for revascularization were assessed through clinical manifestation, coronary angiography, or coronary computed tomography and analyzed with propensity score-adjusted Cox regression, general estimating equation, and competing risk models.Results: Bilateral internal thoracic artery (BITA) grafting was performed in 910 patients (55.0%), and 744 patients (45.0%) received a left internal thoracic artery graft together with at least 1 RA graft. Patients receiving BITA, of whom 187 received an additional RA, showed improved survival (hazard ratio, 0.57; 95% confidence interval [CI], 0.38-0.86; P ¼ .009), major adverse cardiac and cerebrovascular event-free survival (hazard ratio, 0.33; 95% CI, 0.23-0.46; P<.001), and lower need for repeat revascularization (subhzhard ratio, 0.59; 95% CI, 0.39-0.90; P ¼ .015). In a subgroup of 512 patients, comparing 419 RA with 487 saphenous vein grafts, RA grafting showed a lower risk for graft occlusion (odds ratio, 0.59; 95% CI, 0.47-0.73; P<.001) and target revascularization (subhazard ratio, 0.58; 95% CI, 0.43-0.78; P <.001).Conclusions: MAR with BITA and RA grafting revealed to be the recommended strategy in coronary artery bypass grafting to achieve long-term beneficial results. The use of saphenous vein graft showed less favorable outcomes regarding patency and the need for target-vessel revascularization. (J Thorac Cardiovasc Surg 2019;158:442-50) 0.8 0.6 0.4 0.2 0.0 0 3 6 9 Years after CABG Cumulative incidence (revascularization) 12 15 Radial artery Saphenous vein graftNeed for subsequent target-vessel revascularization of radial artery versus saphenous vein grafts. Central MessageThe merits of radial artery over saphenous vein grafting in CABG are clearly demonstrated in this long-term follow-up study.Perspective MAR with BITA and RA grafting revealed to be the recommended strategy in CABG to achieve long-term beneficial results. The use of SVG showed less-favorable outcomes regarding long-term patency and the need for target-vessel revascularization.

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Radial artery grafting in women improves 15-year survival

Abstract: In women undergoing CABG with LITA grafting, use of an RA graft improves survival compared with use of an SV graft.

Cited by 35 publications

References 24 publications

Impact of Gender on Arterial Revascularization Strategies for Coronary Artery Bypass Grafting

Impact of Gender on Arterial Revascularization Strategies for Coronary Artery Bypass Grafting

Coronary Heart Disease in Postmenopausal Women with Type II Diabetes Mellitus and the Impact of Estrogen Replacement Therapy: A Narrative Review

Long-term clinical outcome and graft patency of radial artery and saphenous vein grafts in multiple arterial revascularization

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