Outcomes following surgical revascularization with single versus bilateral internal thoracic arterial grafts in patients with left main coronary artery disease undergoing coronary artery bypass grafting: insights from the EXCEL trial†

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Daniel J F M ThuijsA Pieter Kappetein

Abstract

Observational data suggest that the use of a single internal thoracic artery (SITA) may result in inferior outcomes compared with bilateral internal thoracic artery (BITA) use for coronary artery bypass grafting (CABG)-a finding not yet supported by randomized trial outcomes. However, the optimal number of internal thoracic artery grafts in patients with left main coronary artery disease has not been investigated. The EXCEL trial randomized 1905 patients with left main coronary artery disease to percutaneous coronary intervention with everolimus-eluting stents versus CABG. Among the 905 patients undergoing CABG, 688 (76.0%) received SITA and 217 (24.0%) received BITA. Differences in clinical event rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Multivariable Cox regression was used to adjust for differences in baseline covariates. Compared to SITA, patients treated with BITA were younger (66.1 ± 9.5 vs 64.5 ± 9.3 years, P = 0.020), were less likely female (24.3% vs 14.3%, P = 0.002) and diabetic (28.8% vs 15.2%, P < 0.001), and had a lower prevalence of peripheral vessel disease (10.2% vs 5.5%, P = 0.040). The unadjusted 3-year composite primary endpoint of death, stroke or myocardial inf...Continue Reading

References

Jan 2, 1986·The New England Journal of Medicine·F D LoopW C Sheldon
Apr 30, 1999·The Journal of Thoracic and Cardiovascular Surgery·B W LytleD M Cosgrove
Nov 5, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Giulio RizzoliPierantonio Bellini
Nov 7, 2003·The Annals of Thoracic Surgery·Joseph F SabikDelos M Cosgrove
Nov 25, 2004·The Annals of Thoracic Surgery·Bruce W LytleDelos M Cosgrove
Aug 21, 2007·Interactive Cardiovascular and Thoracic Surgery·Ioannis K ToumpoulisJoel Dunning
Oct 1, 2011·The Annals of Thoracic Surgery·Teresa M KieserUNKNOWN APPROACH Investigators
Feb 8, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Paul A KurlanskyGeorge Ebra
Jan 30, 2015·World Journal of Cardiology·Sofia VainaChristodoulos Stefanadis
May 15, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Graeme L HickeyUNKNOWN EJCTS and ICVTS Editorial Committees
Sep 3, 2016·Journal of the American College of Cardiology·Rafael CavalcantePatrick W Serruys
Sep 19, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Arie Pieter KappeteinGregg W Stone
Nov 1, 2016·The New England Journal of Medicine·Gregg W StoneUNKNOWN EXCEL Trial Investigators
Dec 14, 2016·The New England Journal of Medicine·David P TaggartUNKNOWN ART Investigators
Oct 24, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mario GaudinoStephen Fremes
Dec 3, 2017·Seminars in Thoracic and Cardiovascular Surgery·Thomas A SchwannRobert H Habib

❮ Previous
Next ❯

Citations

Jul 16, 2020·The New England Journal of Medicine·David P Taggart, Mario Gaudino
Aug 3, 2020·Current Opinion in Cardiology·Malak ElbatarnyBobby Yanagawa
Nov 27, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mario GaudinoPhilippe Kolh
Jul 16, 2020·The New England Journal of Medicine·Gregg W StoneJoseph F Sabik
Jun 3, 2020·Journal of Cachexia, Sarcopenia and Muscle·Chan Mi Lee, Jeonghyun Kang
Dec 10, 2020·European Cardiology·Marjan JahangiriJustin Nowell
Oct 8, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Daniel J F M ThuijsUNKNOWN SYNTAX Extended Survival Investigators

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.