دورية أكاديمية
أعرض في EDS

Superior Outcomes of Dual-Arterial Coronary Artery Bypass Grafting Are Maintained in the Veterans Health Administration.

التفاصيل البيبلوغرافية
العنوان: Superior Outcomes of Dual-Arterial Coronary Artery Bypass Grafting Are Maintained in the Veterans Health Administration.
المؤلفون: Gikandi A; Division of Cardiac Surgery, Veterans Affairs (VA) Boston Healthcare System and Harvard Medical School, Boston, Massachusetts; Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Tran D; U.S. Department of Veterans Affairs, VA Cooperative Studies Program Coordinating Center, Office of Research and Development, Perry Point, Maryland., Mi Z; U.S. Department of Veterans Affairs, VA Cooperative Studies Program Coordinating Center, Office of Research and Development, Perry Point, Maryland., DeMatt E; U.S. Department of Veterans Affairs, VA Cooperative Studies Program Coordinating Center, Office of Research and Development, Perry Point, Maryland., Quin JA; Division of Cardiac Surgery, Veterans Affairs (VA) Boston Healthcare System and Harvard Medical School, Boston, Massachusetts., Kinlay S; Division of Cardiology, Veterans Affairs (VA) Boston Healthcare System and Harvard Medical School, Boston, Massachusetts., Biswas K; U.S. Department of Veterans Affairs, VA Cooperative Studies Program Coordinating Center, Office of Research and Development, Perry Point, Maryland., Zenati MA; Division of Cardiac Surgery, Veterans Affairs (VA) Boston Healthcare System and Harvard Medical School, Boston, Massachusetts; Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: marco_zenati@hms.harvard.edu.
المصدر: The Journal of surgical research [J Surg Res] 2024 Sep; Vol. 301, pp. 240-246. Date of Electronic Publication: 2024 Jul 05.
نوع المنشور: Journal Article; Comparative Study; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
مواضيع طبية MeSH: Coronary Artery Bypass*/adverse effects , Coronary Artery Bypass*/methods , Coronary Artery Bypass*/mortality , Coronary Artery Bypass*/statistics & numerical data , United States Department of Veterans Affairs*/statistics & numerical data, Humans ; Male ; Female ; Middle Aged ; Aged ; Cross-Sectional Studies ; United States/epidemiology ; Treatment Outcome ; Coronary Artery Disease/surgery ; Coronary Artery Disease/mortality ; Saphenous Vein/transplantation ; Radial Artery/transplantation ; Mammary Arteries/transplantation ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies
مستخلص: Introduction: Controversy surrounds the long-term clinical benefit of coronary artery bypass grafting (CABG) using dual arterial grafts (DAGs) compared to single arterial grafts (SAGs). We investigated outcomes of DAG, using single internal thoracic artery and radial artery (DAG-RA) or bilateral internal thoracic artery grafts (DAG-BITA), compared to SAG, using the left internal thoracic artery and saphenous vein grafts, in the U.S. Veterans Health Administration (VA).
Methods: We conducted a cross-sectional study of U.S. Veterans undergoing isolated on-pump CABG between 2005 and 2015 at 44 VA medical centers. The primary composite outcome was first occurrence of a major adverse cardiac and cerebrovascular event (MACCE), comprised of death from any cause, myocardial infarction, stroke, or repeat revascularization.
Results: Among 25,969 Veterans undergoing isolated CABG, 1261 (4.9%) underwent DAG (66.8% DAG-RA and 33.2% DAG-BITA). Over a 5-y follow-up, DAG was associated with lower rates of all-cause death (adjusted hazard ratio [AHR] 0.70, 95% confidence interval [CI] 0.58-0.85), MACCE (AHR 0.80, 95% CI 0.71-0.91), and stroke (AHR 0.74, 95% CI 0.57-0.96) versus SAG. DAG-BITA was associated with lower rates of all-cause death (AHR 0.52, 95% CI 0.35-0.77) and MACCE (AHR 0.66, 95% CI 0.51-0.84) than SAG, while DAG-RA was associated with lower rates of all-cause death (AHR 0.79, 95% CI 0.64-0.99).
Conclusions: In the VA, DAG was associated with improved long-term MACCE outcomes compared to SAG. These results suggest that the practice of DAG in the VA benefits Veterans and should be promoted further.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Bilateral internal thoracic artery; Coronary artery bypass grafting; Multiarterial; Radial artery; Veterans
تواريخ الأحداث: Date Created: 20240706 Date Completed: 20240926 Latest Revision: 20240926
رمز التحديث: 20240927
DOI: 10.1016/j.jss.2024.06.013
PMID: 38970871
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-8673
DOI:10.1016/j.jss.2024.06.013