Time-Varying Association of the Second Internal Thoracic Artery with Long-Term Survival after Coronary Artery Bypass Grafting

• DOI: 10.1055/a-2524-9264
• Publication Date: 2025-01-28T00:05:40Z
• Authors: Ibrahim Gadelkarim; Mateo Marin-Cuartas; Sergey Leontyev; Manuela De La Cuesta; Salil V. Deo; Martin Misfeld; Piroze Davierwala; Michael Borger; Alexander Verevkin
• Keywords: Internal thoracic artery

Background: The survival advantages of bilateral internal thoracic artery (BITA) grafts in coronary bypass surgery (CABG) remain unclear. Therefore, this study aims to systematically evaluate the time-dependent influence BITA on long-term elective CABG patients presenting with stable multi-vessel disease. Methods: Data from 3,693 undergoing isolated single (SITA) or BITA, without additional vein grafts, between 2002 and 2012 were retrospectively analyzed. entire cohort was divided into SITA groups (830 vs. 2,863 patients). A 1:3 propensity score matching performed. Subsequent analysis a subgroup meeting ROMA trial criteria (n=1,339) followed 1:1 matching. Differences restricted mean time (RMST) estimates used assess time-varying association survival. Results: In-hospital mortality (SITA 1.8% 1.1%, p=0.2) major postoperative complications similar matched groups. However, significantly higher for whole (15-year survival: 64% 51%, respectively; P<0.001) ROMA-like population (76% 60%, P<0.001). RMST demonstrated an incremental advantage over grafting both populations (0.1, 0.5, 1.1 years, 0.1, 0.4, 1.0 years at 5-, 10-, 15-year follow-up, respectively) Conclusions: is safe associated superior compared benefits extending beyond 5 10 ROMA-criteria patients.