Radial Artery Grafts vs Saphenous Vein Grafts in Coronary Artery Bypass Surgery: A Randomized Trial
CONTEXT Arterial grafts are thought to be better conduits than saphenous vein grafts for coronary artery bypass grafting (CABG) based on experience with using the left internal mammary artery to bypass the left anterior descending coronary artery. The efficacy of the radial artery graft is less clea...
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| creator | Goldman, Steven Sethi, Gulshan K Holman, William Thai, Hoang McFalls, Edward Ward, Herbert B Kelly, Rosemary F Rhenman, Birger Tobler, Gareth H Bakaeen, Faisal G Huh, Joseph Soltero, Ernesto Moursi, Mohammed Haime, Miguel Crittenden, Michael Kasirajan, Vigneshwar Ratliff, Michelle Pett, Stewart Irimpen, Anand Gunnar, William Thomas, Donald Fremes, Stephen Moritz, Thomas Reda, Domenic Harrison, Lynn Wagner, Todd H Wang, Yajie Planting, Lori Miller, Meredith Rodriguez, Yvette Juneman, Elizabeth Morrison, Douglass Pierce, Mary Kaye Kreamer, Sandra Shih, Mei-Chiung Lee, Kelvin |
| description | CONTEXT Arterial grafts are thought to be better conduits than saphenous vein grafts for coronary artery bypass grafting (CABG) based on experience with using the left internal mammary artery to bypass the left anterior descending coronary artery. The efficacy of the radial artery graft is less clear. OBJECTIVE To compare 1-year angiographic patency of radial artery grafts vs saphenous vein grafts in patients undergoing elective CABG. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized controlled trial conducted from February 2003 to February 2009 at 11 Veterans Affairs medical centers among 757 participants (99% men) undergoing first-time elective CABG. INTERVENTIONS The left internal mammary artery was used to preferentially graft the left anterior descending coronary artery whenever possible; the best remaining recipient vessel was randomized to radial artery vs saphenous vein graft. MAIN OUTCOME MEASURES The primary end point was angiographic graft patency at 1 year after CABG. Secondary end points included angiographic graft patency at 1 week after CABG, myocardial infarction, stroke, repeat revascularization, and death. RESULTS Analysis included 733 patients (366 in the radial artery group, 367 in the saphenous vein group). There was no significant difference in study graft patency at 1 year after CABG (radial artery, 238/266; 89%; 95% confidence interval [CI], 86%-93%; saphenous vein, 239/269; 89%; 95% CI, 85%-93%; adjusted OR, 0.99; 95% CI, 0.56-1.74; P = .98). There were no significant differences in the secondary end points. CONCLUSION Among Veterans Affairs patients undergoing first-time elective CABG, the use of a radial artery graft compared with saphenous vein graft did not result in greater 1-year patency. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00054847 |
| doi_str_mv | 10.1001/jama.2010.1976 |
| format | Article |
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The efficacy of the radial artery graft is less clear. OBJECTIVE To compare 1-year angiographic patency of radial artery grafts vs saphenous vein grafts in patients undergoing elective CABG. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized controlled trial conducted from February 2003 to February 2009 at 11 Veterans Affairs medical centers among 757 participants (99% men) undergoing first-time elective CABG. INTERVENTIONS The left internal mammary artery was used to preferentially graft the left anterior descending coronary artery whenever possible; the best remaining recipient vessel was randomized to radial artery vs saphenous vein graft. MAIN OUTCOME MEASURES The primary end point was angiographic graft patency at 1 year after CABG. Secondary end points included angiographic graft patency at 1 week after CABG, myocardial infarction, stroke, repeat revascularization, and death. RESULTS Analysis included 733 patients (366 in the radial artery group, 367 in the saphenous vein group). There was no significant difference in study graft patency at 1 year after CABG (radial artery, 238/266; 89%; 95% confidence interval [CI], 86%-93%; saphenous vein, 239/269; 89%; 95% CI, 85%-93%; adjusted OR, 0.99; 95% CI, 0.56-1.74; P = .98). There were no significant differences in the secondary end points. CONCLUSION Among Veterans Affairs patients undergoing first-time elective CABG, the use of a radial artery graft compared with saphenous vein graft did not result in greater 1-year patency. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00054847</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.2010.1976</identifier><identifier>PMID: 21224458</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Aged ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Clinical outcomes ; Clinical trials ; Coronary Angiography ; Coronary Artery Bypass - methods ; Coronary Artery Disease - surgery ; Coronary heart disease ; Elective Surgical Procedures ; Female ; General aspects ; Heart ; Heart surgery ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction ; Myocardial Revascularization ; Radial Artery - transplantation ; Reoperation ; Saphenous Vein - transplantation ; Stroke ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Treatment Outcome ; Vascular Patency</subject><ispartof>JAMA : the journal of the American Medical Association, 2011-01, Vol.305 (2), p.167-174</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright American Medical Association Jan 12, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.2010.1976$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2010.1976$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76232,76235</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23721535$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21224458$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goldman, Steven</creatorcontrib><creatorcontrib>Sethi, Gulshan K</creatorcontrib><creatorcontrib>Holman, William</creatorcontrib><creatorcontrib>Thai, Hoang</creatorcontrib><creatorcontrib>McFalls, Edward</creatorcontrib><creatorcontrib>Ward, Herbert B</creatorcontrib><creatorcontrib>Kelly, Rosemary F</creatorcontrib><creatorcontrib>Rhenman, Birger</creatorcontrib><creatorcontrib>Tobler, Gareth H</creatorcontrib><creatorcontrib>Bakaeen, Faisal G</creatorcontrib><creatorcontrib>Huh, Joseph</creatorcontrib><creatorcontrib>Soltero, Ernesto</creatorcontrib><creatorcontrib>Moursi, Mohammed</creatorcontrib><creatorcontrib>Haime, Miguel</creatorcontrib><creatorcontrib>Crittenden, Michael</creatorcontrib><creatorcontrib>Kasirajan, Vigneshwar</creatorcontrib><creatorcontrib>Ratliff, Michelle</creatorcontrib><creatorcontrib>Pett, Stewart</creatorcontrib><creatorcontrib>Irimpen, Anand</creatorcontrib><creatorcontrib>Gunnar, William</creatorcontrib><creatorcontrib>Thomas, Donald</creatorcontrib><creatorcontrib>Fremes, Stephen</creatorcontrib><creatorcontrib>Moritz, Thomas</creatorcontrib><creatorcontrib>Reda, Domenic</creatorcontrib><creatorcontrib>Harrison, Lynn</creatorcontrib><creatorcontrib>Wagner, Todd H</creatorcontrib><creatorcontrib>Wang, Yajie</creatorcontrib><creatorcontrib>Planting, Lori</creatorcontrib><creatorcontrib>Miller, Meredith</creatorcontrib><creatorcontrib>Rodriguez, Yvette</creatorcontrib><creatorcontrib>Juneman, Elizabeth</creatorcontrib><creatorcontrib>Morrison, Douglass</creatorcontrib><creatorcontrib>Pierce, Mary Kaye</creatorcontrib><creatorcontrib>Kreamer, Sandra</creatorcontrib><creatorcontrib>Shih, Mei-Chiung</creatorcontrib><creatorcontrib>Lee, Kelvin</creatorcontrib><title>Radial Artery Grafts vs Saphenous Vein Grafts in Coronary Artery Bypass Surgery: A Randomized Trial</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Arterial grafts are thought to be better conduits than saphenous vein grafts for coronary artery bypass grafting (CABG) based on experience with using the left internal mammary artery to bypass the left anterior descending coronary artery. The efficacy of the radial artery graft is less clear. OBJECTIVE To compare 1-year angiographic patency of radial artery grafts vs saphenous vein grafts in patients undergoing elective CABG. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized controlled trial conducted from February 2003 to February 2009 at 11 Veterans Affairs medical centers among 757 participants (99% men) undergoing first-time elective CABG. INTERVENTIONS The left internal mammary artery was used to preferentially graft the left anterior descending coronary artery whenever possible; the best remaining recipient vessel was randomized to radial artery vs saphenous vein graft. MAIN OUTCOME MEASURES The primary end point was angiographic graft patency at 1 year after CABG. Secondary end points included angiographic graft patency at 1 week after CABG, myocardial infarction, stroke, repeat revascularization, and death. RESULTS Analysis included 733 patients (366 in the radial artery group, 367 in the saphenous vein group). There was no significant difference in study graft patency at 1 year after CABG (radial artery, 238/266; 89%; 95% confidence interval [CI], 86%-93%; saphenous vein, 239/269; 89%; 95% CI, 85%-93%; adjusted OR, 0.99; 95% CI, 0.56-1.74; P = .98). There were no significant differences in the secondary end points. CONCLUSION Among Veterans Affairs patients undergoing first-time elective CABG, the use of a radial artery graft compared with saphenous vein graft did not result in greater 1-year patency. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00054847</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Bypass - methods</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary heart disease</subject><subject>Elective Surgical Procedures</subject><subject>Female</subject><subject>General aspects</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction</subject><subject>Myocardial Revascularization</subject><subject>Radial Artery - transplantation</subject><subject>Reoperation</subject><subject>Saphenous Vein - transplantation</subject><subject>Stroke</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Treatment Outcome</subject><subject>Vascular Patency</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkdtLwzAUh4MoOqevgi9SBB87c-kl8W0OncJAmNPXcpqLdqwXk1aYf70p6zQvyeF85wv5BaELgicEY3K7hhImFPelSJMDNCIx4yGLBT9EI4wFD9OIRyfo1Lk19ouw9BidUEJpFMV8hOQSVAGbYGpbbbfB3IJpXfDtgldoPnVVdy5410W1b_jTrLZ1BZ4dRu63DTjPd_bDl3fBNFhCpeqy-NEqWFkvP0NHBjZOnw_7GL09PqxmT-HiZf48my5CoIK2IRWQG8mlIoZjDlgJY4Q0udFaKM4Yj0wcM5mwhKepiqXIDQYMShsaMaoFG6Prnbex9VenXZut685W_sqMRykjxCs8NNlB0tbOWW2yxhalf09GcNZHmvWRZn2kWR-pH7garF1eavWH7zP0wM0AgJOwMRYqWbh_jqXUf0rsucsd1_v3XS5oShL2CwXKh8w</recordid><startdate>20110112</startdate><enddate>20110112</enddate><creator>Goldman, Steven</creator><creator>Sethi, Gulshan K</creator><creator>Holman, William</creator><creator>Thai, Hoang</creator><creator>McFalls, Edward</creator><creator>Ward, Herbert B</creator><creator>Kelly, Rosemary F</creator><creator>Rhenman, Birger</creator><creator>Tobler, Gareth H</creator><creator>Bakaeen, Faisal G</creator><creator>Huh, Joseph</creator><creator>Soltero, Ernesto</creator><creator>Moursi, Mohammed</creator><creator>Haime, Miguel</creator><creator>Crittenden, Michael</creator><creator>Kasirajan, Vigneshwar</creator><creator>Ratliff, Michelle</creator><creator>Pett, Stewart</creator><creator>Irimpen, Anand</creator><creator>Gunnar, William</creator><creator>Thomas, Donald</creator><creator>Fremes, Stephen</creator><creator>Moritz, Thomas</creator><creator>Reda, Domenic</creator><creator>Harrison, Lynn</creator><creator>Wagner, Todd H</creator><creator>Wang, Yajie</creator><creator>Planting, Lori</creator><creator>Miller, Meredith</creator><creator>Rodriguez, Yvette</creator><creator>Juneman, Elizabeth</creator><creator>Morrison, Douglass</creator><creator>Pierce, Mary Kaye</creator><creator>Kreamer, Sandra</creator><creator>Shih, Mei-Chiung</creator><creator>Lee, Kelvin</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope></search><sort><creationdate>20110112</creationdate><title>Radial Artery Grafts vs Saphenous Vein Grafts in Coronary Artery Bypass Surgery: A Randomized Trial</title><author>Goldman, Steven ; Sethi, Gulshan K ; Holman, William ; Thai, Hoang ; McFalls, Edward ; Ward, Herbert B ; Kelly, Rosemary F ; Rhenman, Birger ; Tobler, Gareth H ; Bakaeen, Faisal G ; Huh, Joseph ; Soltero, Ernesto ; Moursi, Mohammed ; Haime, Miguel ; Crittenden, Michael ; Kasirajan, Vigneshwar ; Ratliff, Michelle ; Pett, Stewart ; Irimpen, Anand ; Gunnar, William ; Thomas, Donald ; Fremes, Stephen ; Moritz, Thomas ; Reda, Domenic ; Harrison, Lynn ; Wagner, Todd H ; Wang, Yajie ; Planting, Lori ; Miller, Meredith ; Rodriguez, Yvette ; Juneman, Elizabeth ; Morrison, Douglass ; Pierce, Mary Kaye ; Kreamer, Sandra ; Shih, Mei-Chiung ; Lee, Kelvin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a292t-29abfc8cd1f808a0d9ff9cfbfee9d83384f553c636877d5c9bf0a0adef2432e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Clinical outcomes</topic><topic>Clinical trials</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Bypass - methods</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary heart disease</topic><topic>Elective Surgical Procedures</topic><topic>Female</topic><topic>General aspects</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction</topic><topic>Myocardial Revascularization</topic><topic>Radial Artery - transplantation</topic><topic>Reoperation</topic><topic>Saphenous Vein - transplantation</topic><topic>Stroke</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. 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The efficacy of the radial artery graft is less clear. OBJECTIVE To compare 1-year angiographic patency of radial artery grafts vs saphenous vein grafts in patients undergoing elective CABG. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized controlled trial conducted from February 2003 to February 2009 at 11 Veterans Affairs medical centers among 757 participants (99% men) undergoing first-time elective CABG. INTERVENTIONS The left internal mammary artery was used to preferentially graft the left anterior descending coronary artery whenever possible; the best remaining recipient vessel was randomized to radial artery vs saphenous vein graft. MAIN OUTCOME MEASURES The primary end point was angiographic graft patency at 1 year after CABG. Secondary end points included angiographic graft patency at 1 week after CABG, myocardial infarction, stroke, repeat revascularization, and death. RESULTS Analysis included 733 patients (366 in the radial artery group, 367 in the saphenous vein group). There was no significant difference in study graft patency at 1 year after CABG (radial artery, 238/266; 89%; 95% confidence interval [CI], 86%-93%; saphenous vein, 239/269; 89%; 95% CI, 85%-93%; adjusted OR, 0.99; 95% CI, 0.56-1.74; P = .98). There were no significant differences in the secondary end points. CONCLUSION Among Veterans Affairs patients undergoing first-time elective CABG, the use of a radial artery graft compared with saphenous vein graft did not result in greater 1-year patency. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00054847</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>21224458</pmid><doi>10.1001/jama.2010.1976</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2011-01, Vol.305 (2), p.167-174 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_journals_847311384 |
| source | MEDLINE; American Medical Association Journals |
| subjects | Aged Biological and medical sciences Cardiology Cardiology. Vascular system Clinical outcomes Clinical trials Coronary Angiography Coronary Artery Bypass - methods Coronary Artery Disease - surgery Coronary heart disease Elective Surgical Procedures Female General aspects Heart Heart surgery Humans Male Medical sciences Middle Aged Myocardial Infarction Myocardial Revascularization Radial Artery - transplantation Reoperation Saphenous Vein - transplantation Stroke Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Treatment Outcome Vascular Patency |
| title | Radial Artery Grafts vs Saphenous Vein Grafts in Coronary Artery Bypass Surgery: A Randomized Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T17%3A49%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Radial%20Artery%20Grafts%20vs%20Saphenous%20Vein%20Grafts%20in%20Coronary%20Artery%20Bypass%20Surgery:%20A%20Randomized%20Trial&rft.jtitle=JAMA%20:%20the%20journal%20of%20the%20American%20Medical%20Association&rft.au=Goldman,%20Steven&rft.date=2011-01-12&rft.volume=305&rft.issue=2&rft.spage=167&rft.epage=174&rft.pages=167-174&rft.issn=0098-7484&rft.eissn=1538-3598&rft.coden=JAMAAP&rft_id=info:doi/10.1001/jama.2010.1976&rft_dat=%3Cproquest_cross%3E2248795441%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=847311384&rft_id=info:pmid/21224458&rft_ama_id=892716&rfr_iscdi=true |