Clinical recurrence in patients with sequential grafts in Coronary Artery Bypass Graft (CABG) surgery

Abstract

Objective: The objective of this study was to compare the recurrence rates of revascularization (redo coronary artery bypass graft [CABG] or percutaneous coronary intervention [PCI]), new ischemic event, or death in patients with simple or sequential grafts in CABG surgery. Methods: The study design is an ambispective cohort of patients that underwent CABG by sequential grafting (n = 111) or simple grafting (n = 145) between January 1, 2013 and December 31, 2017. Patients had to be 18 years old at the time of surgery, undergoing their first on-pump CABG. The clinical record of every patient was carefully reviewed and patients who had incomplete follow-up in external consultation were contacted by telephone to obtain data about ischemia related reintervention (CABG or PCI), new documented ischemic event, or death caused by coronary artery disease, Kaplan-Meier estimators were calculated. Results: The proportion of recurrence depending on technique was not statistically different: sequential (6.5% [CI 95% 2.6-12.6%] versus simple 4.8% [CI 95% 2-9.7%], p = 0.60, Bayesian analysis BF 10 = 0.37; moderate evidence to no difference), each one related to new ischemic event and one death per group. There were no differences in follow-up time (sequential 59m simple 66m ). No difference was found regarding recurrence incidence rates; sequential 1.99 events × 10 3 months-patient, versus simple 1.47 (HR=1.34; p = 0.58). Pump and cross-clamping times were lower for sequential technique (41.44 min; 24.69 min respectively) versus simple technique (43 min and 26.4 min, respectively) with a p = 0.7 after adjusting to mean grafts per surgery (2.7 simple; 3.25 sequential, p < 0.001). Conclusions: Both techniques had a low incidence of clinical recurrence, without significant differences between procedures.