Association of age with 10-year outcomes after coronary surgery in the Arterial Revascularization Trial

Gaudino, Mario, Di Franco, Antonino, Flather, Marcus, Gerry, Stephen, Bagiella, Emilia, Gray, Alastair, Pearcey, Leon, Saw, Teng-Hui, Lees, Belinda, Benedetto, Umberto, Fremes, Stephen E. and Taggart, David P. (2021) Association of age with 10-year outcomes after coronary surgery in the Arterial Revascularization Trial. Journal of the American College of Cardiology, 77 (1). pp. 18-26. ISSN 0735-1097

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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.

Item Type: Article
Uncontrolled Keywords: cabg,bilateral internal thoracic arteries,single internal thoracic artery,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2705
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 03 Mar 2021 00:42
Last Modified: 22 Oct 2022 07:42
DOI: 10.1016/j.jacc.2020.10.047

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