Abstract:
BACKGROUND:Limited information exists on the intermediate-term graft patency and 5-year clinical outcomes of patients receiving saphenous vein grafts with multiple (m-SVG) versus single distal targets (s-SVG) during coronary artery bypass graft (CABG) surgery in the current era. METHODS AND RESULTS:We studied the association of the use of m-SVG versus s-SVG conduits with 1-year SVG failure (defined as ≥75% angiographic stenosis) and 5-year clinical events (death; death or myocardial infarction [MI]; and death, MI, or revascularization) in 3014 patients undergoing their first CABG surgery enrolled in the Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV. Of 3014 patients enrolled in PREVENT IV, 1045 (34.7%) had ≥1 m-SVGs during CABG. Vein graft failure at 1-year was higher for m-SVG compared with s-SVG (adjusted odds ratio 1.24, 95% confidence interval 1.03 to 1.48). At 5 years, the adjusted composite of death, MI (including perioperative MI), or revascularization (hazard ratio 1.15, 95% confidence interval 1.00 to 1.31) and death or MI (hazard ratio 1.21, 95% confidence interval 1.03 to 1.43) were significantly higher in patients receiving m-SVGs. CONCLUSIONS:In patients undergoing first CABG surgery, the use of m-SVG was associated with a higher 1-year vein graft failure rate and trends toward worse clinical outcomes. Additional studies are needed to better understand the most appropriate conduit to improve long-term graft patency and clinical outcomes of patients undergoing CABG surgery. In the meantime, these data should encourage the use of s-SVG over m-SVG when feasible.
journal_name
Circulationjournal_title
Circulationauthors
Mehta RH,Ferguson TB,Lopes RD,Hafley GE,Mack MJ,Kouchoukos NT,Gibson CM,Harrington RA,Califf RM,Peterson ED,Alexander JH,Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT) IV Investigators.doi
10.1161/CIRCULATIONAHA.110.991299subject
Has Abstractpub_date
2011-07-19 00:00:00pages
280-8issue
3eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.110.991299journal_volume
124pub_type
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