SITA+Vein vs 2nd-arterial conduit
Baseline characteristics of patients in the unmatched and matched cohort
are presented in Table-1. In the unmatched cohort, patients in the
SITA+Vein group presented higher prevalence of comorbidities. In
particular they were more likely to be older, female and to have
peripheral vascular disease, diabetes, history of cerebrovascular
adverse events, recent myocardial infarction, impaired left ventricular
function, moderate and severe renal impairment. Whereas patients in the
2nd arterial conduit group were more likely to be
active smokers and emergent or urgent cases and to have history of
percutaneous coronary interventions, hyperlipidemia and left main
disease. After PS-matching, both groups were comparable for all baseline
characteristics(Table-1). PS-matching selected 695-pairs and both groups
were found to be well balanced.
The mean number of grafts performed in the SITA+Vein group was higher
than in the 2nd-arterial conduit group
before(p<0.001) as well as after
PS-matching(p<0.001). In the unmatched, no difference was
observed between both groups in terms of OPCAB vs ONCAB or prevalence of
IR. However, after matching, 2nd-arterial conduit
group had higher rate of OPCAB(46.9% vs 36.9% in the SITA+Vein
group;p<0.001) and higher rate of IR(25.8% vs 20.0% in the
SITA+Vein group;p=0.008)(Table-1).
Before as well as after PS-matching, no significant differences were
observed between both groups in terms of 30-day mortality, 30-day MACCE,
reoperation for bleeding and incidence of DSWI(Table-2).
In the unmatched cohort, mean follow‐up was 7.2±3.66-years. Survival
at-5,-10 and 14-years were 92.6% vs 85.6%, 80.2% vs 68.1% and 73.2%
vs 54.8% in the 2nd arterial conduit group vs
SITA+Vein group, respectively(Log-rank p<0.001)(Figure.2A). In
the matched cohort, mean follow-up was 7.74±3.79-years. Survival
at-5,-10 and 14-years were 92.6% vs 89.7%, 79.9% vs 78.3% and 72.4%
vs 61.1% in the 2nd arterial conduit group vs
SITA+Vein group, respectively(Log-rank p=0.04)(Figure.2B). The use of
2nd-arterial graft was associated with a significant
reduction in long-term mortality
before(HR:0.52;95%CI;0.43-0.64;p<0.001) as well as after
PS-matching(HR:0.77;95%CI;0.60-0.99;p=0.04).
Cox regression models were used to find the univariable and
multivariable predictors of late all-cause mortality. Multivariable
analysis identified the presence of 2nd-arterial
conduit as a significant predictor of improved
survival(HR:0.67;95%CI;0.55-0.82;p<0.001). Other significant
predictors for increased late mortality were age>70, NYHA
III-IV, smoking, diabetes, severe renal impairment, peripheral vascular
disease, history of cerebrovascular adverse events, chronic lung
disease, left main disease, IR, impaired LV function and urgent/emergent
cases(Table-3).