Graft Failure After Coronary Artery Bypass Grafting and Its Association With Patient Characteristics and Clinical Events: A Pooled Individual Patient Data Analysis of Clinical Trials With Imaging Follow-Up

• DOI: 10.1161/circulationaha.123.064090
• Publication Date: 2023-07-07T09:00:17Z
• Authors: Mario Gaudino; Sigrid Sandner; Kevin R. An; Arnaldo Dimagli; Antonino Di Franco; Katia Audisio; Lamia Harik; Roberto Perezgrov...; Giovanni Soletti; Stephen E. Fremes; David L. Hare; Alexander Kulik; Andre Lamy; Joyce Peper; Marc Ruel; Jurrien M. ten Berg; Laura M. Willemsen; Qiang Zhao; Daniel M. Wojdyla; Deepak L. Bhatt; John H. Alexander; Bjorn Redfors
• Keywords: Interquartile range

Graft patency is the postulated mechanism for benefits of coronary artery bypass grafting (CABG). However, systematic graft imaging assessment after CABG rare, and there a lack contemporary data on factors associated with failure association between clinical events CABG. We pooled individual patient from randomized trials to assess incidence its risk factors. The primary outcome was composite myocardial infarction or repeat revascularization occurring before imaging. A 2-stage meta-analytic approach used evaluate outcome. also assessed infarction, revascularization, all-cause death Seven were included comprising 4413 patients (mean age, 64.4±9.1 years; 777 [17.6%] women; 3636 [82.4%] men) 13 163 grafts (8740 saphenous vein 4423 arterial grafts). median time 1.02 years (interquartile range [IQR], 1.00-1.03). occurred in 1487 (33.7%) 2190 (16.6%) grafts. Age (adjusted odds ratio [aOR], 1.08 [per 10-year increment] [95% CI, 1.01-1.15]; P=0.03), female sex (aOR, 1.27 1.08-1.50]; P=0.004), smoking 1.20 1.04-1.38]; P=0.01) independently failure, whereas statins protective effect 0.74 0.63-0.88]; P<0.001). an increased (8.0% versus 1.7% without failure; aOR, 3.98 3.54-4.47]; (7.8% 2.0%; 2.59 1.86-3.62]; All-cause more frequently compared (11.0% 2.1%; 2.79 2.01-3.89]; In practice, remains common among undergoing strongly adverse cardiac events.