The influence of bilateral internal mammary arteries on short- and long-term outcomes: A propensity score matching in accordance with current recommendations

Benedetto, Umberto; Amrani, Mohamed; Gaer, Jullien; Bahrami, Toufan; Robertis, Fabio De; Simón, A.; Raja, Shahzad G.

doi:10.1016/j.jtcvs.2014.08.021

Cited by 50 publications

(43 citation statements)

References 23 publications

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“…In our analysis, the rate of mediastinitis or sternal dehiscence was 2.8% in BIMA patients versus 1.8% in SIMA patients; this difference did not achieve statistical significance. Current literature on the association between multiarterial grafting and sternal wound complications is mixed, with some demonstrating no association and others showing a slightly increased risk [19][20][21]. A recent literature review by Dai and colleagues showed that whereas BIMA grafting resulted in an increase in sternal wound infections, the associated risk was blunted when the IMA was harvested in a skeletonized fashion [19].…”

Section: Commentmentioning

confidence: 99%

“…Multiple retrospective analyses have demonstrated that patients undergoing CABG with bilateral internal mammary artery (BIMA) grafting have significantly improved survival and freedom from repeat revascularization when compared with patients receiving a single internal mammary artery (SIMA) [15][16][17][18]. The observed clinical benefits of a BIMA approach have been tempered, however, by concerns over the risk of sternal wound complications among the obese and diabetics [19][20][21]. Moreover, in the recently published 5-year interim analysis of the Arterial Revascularization Trial (ART), Taggart and colleagues reported a significant increase risk of sternal wound complications among BIMA patients [22].…”

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confidence: 99%

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Should Diabetes Be a Contraindication to Bilateral Internal Mammary Artery Grafting?

Iribarne

Westbrook

Malenka

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 99%

mentioning

confidence: 99%

Should Diabetes Be a Contraindication to Bilateral Internal Mammary Artery Grafting?

Iribarne

Westbrook

Malenka

et al. 2018

The Annals of Thoracic Surgery

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“…A second arterial conduit to a non‐LAD target has less potential to impact on overall survival than the single left internal thoracic artery to the LAD. Solid evidence suggests, in fact, that in coronary artery bypass surgery, patient survival is mainly determined by the status of the LAD and that grafts to non‐LAD vessels are more likely to affect other cardiac end points (myocardial infarction, angina recurrence, and need for revascularization), but not overall survival . The LAD also can provide collaterals to other coronaries (commonly the right coronary); a persistently patent internal thoracic artery graft to the LAD can therefore supply not only the anterior wall, but, through collaterals, viable myocardium in other territories.…”

Section: Discussionmentioning

confidence: 99%

Unmeasured Confounders in Observational Studies Comparing Bilateral Versus Single Internal Thoracic Artery for Coronary Artery Bypass Grafting: A Meta‐Analysis

Gaudino

Franco

Rahouma

et al. 2018

JAHA

104

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BackgroundObservational studies suggest a survival advantage with bilateral single internal thoracic artery (BITA) versus single internal thoracic artery grafting for coronary surgery, whereas this conclusion is not supported by randomized trials. We hypothesized that this inconsistency is attributed to unmeasured confounders intrinsic to observational studies. To test our hypothesis, we performed a meta‐analysis of the observational literature comparing BITA and single internal thoracic artery, deriving incident rate ratio for mortality at end of follow‐up and at 1 year. We postulated that BITA would not affect 1‐year survival based on the natural history of coronary artery bypass occlusion, so that a difference between groups at 1 year could not be attributed to the intervention.Methods and ResultsWe searched MEDLINE and Pubmed to identify all observational studies comparing the outcome of BITA versus single internal thoracic artery. One‐year and long‐term mortality for BITA and single internal thoracic artery were compared in the propensity‐score–matched (PSM) series, that is, the form of observational evidence less prone to confounders. Thirty‐eight observational studies (174 205 total patients) were selected for final comparison. In the 12 propensity‐score–matched series (34 019 patients), the mortality reduction for BITA was similar at 1 year and at the end of follow‐up (incident rate ratio, 0.70; 95% confidence interval, 0.60–0.82 versus 0.77; 95% confidence interval, 0.70–0.85; P for subgroup difference=0.43).ConclusionsUnmeasured confounders, rather than biological superiority, may explain the survival advantage of BITA in observational series.

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“…This difference is a potential future issue since there are growing burden of published studies showing better long-term survival in patients receiving bilateral ITA compared with s ingle ITA grafting [53][54][55][56].…”

Section: Sex-specific Outcomes Following Cabgmentioning

confidence: 99%

Sex differences in clinical outcomes following coronary revascularization

Lee¹,

Park²

2015

Interventional Cardiology

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There have been several reports suggesting that the response to treatment for patients with significant coronary heart disease was not equal among males and females. Most of the early investigations on sex differences after surgical or percutaneous coronary revascularization suggested worse clinical outcomes in females compared with male counterparts. However, along with the advent of new revascularization techniques and devices, recent trials have shown somewhat narrowed sex-based differences in cardiovascular outcomes. Given that sex-based difference in outcomes and prognosis is still an important ongoing issue, this article systematically reviewed the cumulative evidence from key clinical studies and tried to help guide the physician in making sex-specific treatment decisions for patients with significant coronary heart disease requiring coronary revascularization.

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The influence of bilateral internal mammary arteries on short- and long-term outcomes: A propensity score matching in accordance with current recommendations

Abstract: When compared with SIMA grafting, BIMA use did not increase operative morbidity and mortality and was associated with a better long-term survival.

Cited by 50 publications

References 23 publications

Should Diabetes Be a Contraindication to Bilateral Internal Mammary Artery Grafting?

Should Diabetes Be a Contraindication to Bilateral Internal Mammary Artery Grafting?

Unmeasured Confounders in Observational Studies Comparing Bilateral Versus Single Internal Thoracic Artery for Coronary Artery Bypass Grafting: A Meta‐Analysis

Sex differences in clinical outcomes following coronary revascularization

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