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Association of Age With 10-Year Outcomes After Coronary Surgery in the Arterial Revascularization Trial
Journal of the American College of Cardiology ( IF 24.0 ) Pub Date : 2021-01-01 , DOI: 10.1016/j.jacc.2020.10.047
Mario Gaudino , Antonino Di Franco , Marcus Flather , Stephen Gerry , Emilia Bagiella , Alastair Gray , Leon Pearcey , Teng-Hui Saw , Belinda Lees , Umberto Benedetto , Stephen E. Fremes , David P. Taggart

BACKGROUND The association of age with the outcomes of bilateral internal thoracic arteries (BITAs) versus single internal thoracic arteries (SITAs) for coronary bypass grafting (CABG) remains to be determined. OBJECTIVES The purpose of this study was to evaluate the association between age and BITA versus SITA outcomes in the Arterial Revascularization Trial. METHODS The primary endpoints were all-cause mortality and a composite of major adverse events, including all-cause mortality, myocardial infarction, or stroke. Secondary endpoints were bleeding complications and sternal wound complications up to 6 months after surgery. Multivariable fractional polynomials analysis and log-rank tests were used. RESULTS Age did not affect any of the explored outcomes in the overall BITA versus SITA comparison in the intention-to-treat analysis and in the analysis based on the number of arterial grafts received. However, when the intention-to-treat analysis was restricted to the populations of patients between age 50 and 70 years, younger patients in the BITA arm had a significantly lower incidence of major adverse events (p = 0.03). CONCLUSIONS Our results suggest that BITA may improve long-term outcome in younger patients, although more randomized data are needed to confirm this hypothesis.

中文翻译:

动脉血运重建试验中年龄与冠状动脉手术后 10 年结果的关联

背景 年龄与双侧胸内动脉 (BITA) 与单侧胸内动脉 (SITA) 进行冠状动脉旁路移植术 (CABG) 的结果之间的关系仍有待确定。目的 本研究的目的是评估动脉血运重建试验中年龄与 BITA 与 SITA 结果之间的关联。方法主要终点是全因死亡率和主要不良事件的复合,包括全因死亡率、心肌梗塞或中风。次要终点是手术后长达 6 个月的出血并发症和胸骨伤口并发症。使用了多变量分数多项式分析和对数秩检验。结果 在意向治疗分析和基于接受的动脉移植物数量的分析中,年龄不影响总体 BITA 与 SITA 比较中的任何探索结果。然而,当意向治疗分析仅限于 50 至 70 岁的患者人群时,BITA 组中年轻患者的主要不良事件发生率显着降低(p = 0.03)。结论 我们的结果表明 BITA 可能会改善年轻患者的长期预后,尽管需要更多的随机数据来证实这一假设。BITA 组中年轻患者的主要不良事件发生率显着降低(p = 0.03)。结论 我们的结果表明 BITA 可能会改善年轻患者的长期预后,尽管需要更多的随机数据来证实这一假设。BITA 组中年轻患者的主要不良事件发生率显着降低(p = 0.03)。结论 我们的结果表明 BITA 可能会改善年轻患者的长期预后,尽管需要更多的随机数据来证实这一假设。
更新日期:2021-01-01
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